☰ INDEX
ANS_Pharmacology-ANS_Introduction_and_Cholinergic_Drugs
ANS_Pharmacology-Anticholinergic_Drugs
ANS_Pharmacology-Previous_Year_Questions
ANS_Pharmacology-Sympatholytics
ANS_Pharmacology-Sympathomimetics
Anaesthesia-Anaesthetic_Pharmacology
Anaesthesia-Previous_Year_Questions
Anticancer_Drugs-Cytotoxic_drugs
Anticancer_Drugs-Previous_Year_Questions
Anticancer_Drugs-Targeted_Therapy_and_Monoclonal_Antibodies
Antimicrobials-Anti-Parasitic_and_Anti_Protozoal_Drugs
Antimicrobials-Anti-mycobacterial_drugs
Antimicrobials-Antifungal_Drugs
Antimicrobials-Antimetabolites_and_Fluroquinolones
Antimicrobials-Antiviral_Drugs
Antimicrobials-Cell_Wall_Synthesis_Inhibitors
Antimicrobials-Previous_Year_Questions
Antimicrobials-Properties_of_Anti-microbial_Agents
Antimicrobials-Protein_Synthesis_Inhibitors
Autacoids-Gout_and_Rheumatoid_Arthritis
Autacoids-Histamine__Serotonin_and_Lipid_Autocoids
Autacoids-Non_Steroidal_Anti_Inflammatory_Drugs
Autacoids-Previous_Year_Questions
CNS_Pharmacology-Anti_Epileptic_Drugs
CNS_Pharmacology-Antipsychotics_and_Antidepressants
CNS_Pharmacology-Opioids
CNS_Pharmacology-Parkinson_s_Disease_and_Other_Disorders
CNS_Pharmacology-Previous_Year_Questions
CNS_Pharmacology-Sedatives_Hypnotics__Drugs_for_Insomnia__and_Alcohol
CVS_Pharmacology-Anti_Anginal_drugs
CVS_Pharmacology-Antihypertensives
CVS_Pharmacology-Hypolipidemic_Drugs_and_Anti-Arrhythmic_Drugs
CVS_Pharmacology-Myocardial_Infarction___Drugs_for_Heart_Failure
CVS_Pharmacology-Previous_Year_Questions
Drugs_Affecting_Blood_and_Blood_formation-Anti_Platelets_and_Pro_Platelets__Thrombolytics_and_Anti_Thrombolytics
Drugs_Affecting_Blood_and_Blood_formation-Hematinics__Iron__and_Chelators
Drugs_Affecting_Blood_and_Blood_formation-Oral_and_Parenteral_Anticoagulants
Drugs_Affecting_Blood_and_Blood_formation-Previous_Year_Questions
Endocrine_Pharmacology-Antithyroid_Drugs
Endocrine_Pharmacology-Corticosteroids_and_Sex_Hormones
Endocrine_Pharmacology-HPA_Axis_and_Drugs_acting_on_Bone_and_Osteoporosis
Endocrine_Pharmacology-Oral_Hypoglycemic_Drugs
Endocrine_Pharmacology-Parenteral_Hypoglycemic_Drugs
Endocrine_Pharmacology-Previous_Year_Questions
GIT_Pharmacology-Drugs_in_Acid_Peptic_Disease
GIT_Pharmacology-GIT_Miscellaneous
GIT_Pharmacology-Laxatives_and_Anti-Diarrheal_Drugs
GIT_Pharmacology-Previous_Year_Questions
General_Pharmacology-Clinical_Trials_and_Miscellaneous
General_Pharmacology-Pharmacodynamics
General_Pharmacology-Pharmacokinetics
General_Pharmacology-Previous_Year_Questions
Immunomodulator_Drugs-Previous_Year_Questions
Introduction_to_Pharmacology-Previous_Year_Questions
Renal_Pharmacology-Diuretics_and_Antidiuretics
Renal_Pharmacology-Previous_Year_Questions
Respiratory_Pharmacology-Previous_Year_Questions
Respiratory_Pharmacology-Respiratory_Pharmacology
Special_Topics-Previous_Year_Questions
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An ECG reveals ST-segment elevation in the inferior leads. Her blood pressure is 90/60 mm Hg, and her pulse is 42/min. The appropriate therapy is initiated, including medication to treat her bradycardia. The medication improved her vitals, but she now complains of severe right eye pain. Which of the following drugs can be used to treat this patient?", "options": [{"label": "A", "text": "Phenylephrine", "correct": false}, {"label": "B", "text": "Pyridostigmine", "correct": false}, {"label": "C", "text": "Pilocarpine", "correct": true}, {"label": "D", "text": "Bethanechol", "correct": false}], "correct_answer": "C. Pilocarpine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/I6eSDGvmmV9KbIWYjz6E1747127966.mp3", "video": ""}, {"text": "A 68 y/o man with a history of Parkinson’s disease is scheduled for a laparoscopic cholecystectomy. He is experiencing excessive salivation and drooling due to his Parkinson's disease. Which of the following medications would be most appropriate to administer before surgery to reduce his salivary secretions?", "options": [{"label": "A", "text": "Glycopyrrolate", "correct": true}, {"label": "B", "text": "Neostigmine", "correct": false}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Bethanechol", "correct": false}], "correct_answer": "A. Glycopyrrolate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/psh7z8O1prcWElimNm8P1747129702.mp3", "video": ""}, {"text": "A 30 y/o woman presents to the emergency department with acute angle-closure glaucoma. Her intraocular pressure is markedly elevated. Which of the following medications is most appropriate for lowering her intraocular pressure?", "options": [{"label": "A", "text": "Ipratropium", "correct": false}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Carbachol", "correct": true}, {"label": "D", "text": "Scopolamine", "correct": false}], "correct_answer": "C. Carbachol", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7oDDiylFBACSm0Ws1QOZ1747129548.mp3", "video": ""}, {"text": "A 68 y/o woman with a long history of diabetes presents with complaints of frequent urinary tract infections and difficulty emptying her bladder. She reports feeling like she needs to urinate urgently, but when she tries to go, very little urine comes out. After ruling out a urinary tract obstruction, which medication would be most appropriate to address her symptoms?", "options": [{"label": "A", "text": "Bethanechol", "correct": true}, {"label": "B", "text": "Pilocarpine", "correct": false}, {"label": "C", "text": "Atropine", "correct": false}, {"label": "D", "text": "Edrophonium", "correct": false}], "correct_answer": "A. Bethanechol", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gzSdNfhGL5VSHaExhfdW1747129386.mp3", "video": ""}, {"text": "Which of the following would possibly confirm the diagnosis of myasthenia gravis following an Edrophonium test?", "options": [{"label": "A", "text": "No change in muscle strength after administration of edrophonium", "correct": false}, {"label": "B", "text": "Worsening of muscle weakness after administration of edrophonium", "correct": false}, {"label": "C", "text": "Temporary improvement in muscle strength after administration of edrophonium", "correct": true}, {"label": "D", "text": "Development of severe muscle cramps after administration of edrophonium", "correct": false}], "correct_answer": "C. Temporary improvement in muscle strength after administration of edrophonium", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/F1KX1DatPmujlSxOoUfg1747129251.mp3", "video": ""}, {"text": "A 45-year-old woman presents with generalised weakness, ptosis, diplopia, and difficulty swallowing. She reports that her symptoms worsen with exertion and improve with rest. After a thorough evaluation, the physician suspects a neuromuscular junction disorder and prescribes a medication to enhance neuromuscular transmission. Which of the following medications is most appropriate for managing the patient's symptoms?", "options": [{"label": "A", "text": "Edrophonium", "correct": false}, {"label": "B", "text": "Pyridostigmine", "correct": true}, {"label": "C", "text": "IV-Ig", "correct": false}, {"label": "D", "text": "Atropine", "correct": false}], "correct_answer": "B. Pyridostigmine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pBM7xcD4V3BlVtTYvj5W1747129142.mp3", "video": ""}, {"text": "Neostigmine is commonly used in clinical practice for several medical conditions. Which of the following is NOT an appropriate use of Neostigmine?", "options": [{"label": "A", "text": "Treatment of myasthenia gravis", "correct": false}, {"label": "B", "text": "Reversal of non-depolarizing neuromuscular blockade after surgery", "correct": false}, {"label": "C", "text": "Management of urinary retention", "correct": false}, {"label": "D", "text": "Treatment of Alzheimer's disease", "correct": true}], "correct_answer": "D. Treatment of Alzheimer's disease", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ocRQgBGt3b2KFUixgcdh1747128972.mp3", "video": ""}, {"text": "A 65-year-old patient is being treated for myasthenia gravis and requires a medication that acts peripherally without affecting the central nervous system. Which of the following carbamate drugs cannot cross the blood-brain barrier and is appropriate for this patient?", "options": [{"label": "A", "text": "Physostigmine", "correct": false}, {"label": "B", "text": "Neostigmine", "correct": true}, {"label": "C", "text": "Donezpezil", "correct": false}, {"label": "D", "text": "Rivastigmine", "correct": false}], "correct_answer": "B. Neostigmine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2Skg9cLSTB4FAtzG8fyw1734420554.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ogb5T2idIsGIZfq6ezYL1747128823.mp3", "video": ""}, {"text": "Which of the following is the first-line drug of choice for managing mild to moderate symptoms of Alzheimer's disease?", "options": [{"label": "A", "text": "Memantine", "correct": false}, {"label": "B", "text": "Donepezil", "correct": true}, {"label": "C", "text": "Rivastigmine", "correct": false}, {"label": "D", "text": "Galantamine", "correct": false}], "correct_answer": "B. Donepezil", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wP9DrXAxfGX2CZPOjaQK1747128540.mp3", "video": ""}, {"text": "Which of the following is a reversible anticholinesterase?", "options": [{"label": "A", "text": "Sarin", "correct": false}, {"label": "B", "text": "Malathion", "correct": false}, {"label": "C", "text": "Tabun", "correct": false}, {"label": "D", "text": "Tacrine", "correct": true}], "correct_answer": "D. Tacrine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/aQxcRTFl5HRrm9dEOYwr1734420485.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uLmU0WeVG5rSJHqljN6t1747128444.mp3", "video": ""}, {"text": "A 30-year-old woman presents with severe nausea, vomiting, abdominal pain, and diarrhea. She reports foraging for wild mushrooms earlier in the day and consuming them in a meal. Upon further questioning, it is discovered that she is experiencing visual disturbances and confusion. Physical examination reveals jaundice and signs of dehydration. Which of the following toxins is the likely culprit?", "options": [{"label": "A", "text": "Amatoxin", "correct": true}, {"label": "B", "text": "Bungarotoxin", "correct": false}, {"label": "C", "text": "Muscarine", "correct": false}, {"label": "D", "text": "Muscimol", "correct": false}], "correct_answer": "A. Amatoxin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:652px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early mushroom poisoning</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Late mushroom poisoning</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hallucinogenic mushroom poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Species</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inocybe</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amanita phalloides</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amanita muscaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Toxin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscarine<strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amatoxin <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscimol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cholinergic symptoms (DUMBBELLS)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hallucinations, seizures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atropine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thioctic acid</p>\n<p>Silibinin</p>\n<p>(hepatoprotective)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supportive treatment</p>\n<p>ATROPINE CONTRAINDICATED</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/si7Y88dElioq8gZw5sqH1747128345.mp3", "video": ""}, {"text": "A 45-year-old male presents with a chronic cough and shortness of breath. Upon further inquiry, it is revealed that he has been a smoker for 20 years, averaging a pack a day. His doctor discusses the risks of smoking and recommends nicotine cessation drugs to help him quit. Which of the following may be prescribed first-line?", "options": [{"label": "A", "text": "Topiramate", "correct": false}, {"label": "B", "text": "Clonidine", "correct": false}, {"label": "C", "text": "Nortriptyline", "correct": false}, {"label": "D", "text": "Bupropion", "correct": true}], "correct_answer": "D. Bupropion", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:719px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on Smoking Cessation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First-Line Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bupropion<br/>\n<strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> and <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> in the brain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nicotine Replacement Therapy (NRT)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Provides controlled <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> dose (patches, gum, lozenges, inhalers). Never given orally, <span class=\"customMeta\" data-dictid=\"75089cc39e1692777199b8933bd249\">sublingual</span> due to its fast absorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alleviates <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings, gradually reducing <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> dependence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Varenicline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> receptors in the brain, partially stimulating them.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most effective drug.</p>\n<p>Reduces cravings and pleasurable effects of smoking.</p>\n<p>Used in tobacco chewing.<br/>\n\t\t\tS/E: Depression (suicides)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All first-line drugs are C/I in seizures and heart diseases (MI, angina, hypertension)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second-Line Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clonidine<br/>\n<strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alpha-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> agonist, reduces <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> nervous system activity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alleviates <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> such as anxiety, irritability, and restlessness.<br/>\n\t\t\tSafe in patients with heart disease/seizure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nortriptyline</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tricyclic antidepressant, affecting <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> and <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> levels</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Topiramate</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors and facilitates <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> neurotransmission</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potentially facilitates smoking cessation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mecamylamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> receptors in the brain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces the rewarding effects of nicotine, making smoking less appealing.</p>\n<p>Used in <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> poisoning.</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:556px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First line</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second line</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nicotine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clonidine (safe in heart diseases)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Varenicline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nortriptyline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bupropion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Off-label: Topiramate/ Mecamylamine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WSdkwiDZdGSslE3kO2Tz1745660542.mp3", "video": ""}, {"text": "Match the drugs with their mechanism of action: Drug Action 1. Neostigmine a) Inhibits acetylcholinesterase in the CNS 2. Galantamine b) Inhibits acetylcholinesterase at the neuromuscular junction 3. Bethanechol c) Inhibits acetylcholinesterase at both the central and peripheral nervous system 4- Physostigmine d) Direct-acting cholinergic agonist at muscarinic receptors", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-d, 2-a, 3-b, 4-c", "correct": false}, {"label": "C", "text": "1-c, 2-a, 3-d, 4-b", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-d, 4-c", "correct": true}], "correct_answer": "D. 1-b, 2-a, 3-d, 4-c", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:667px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Neostigmine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> at the <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> junction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Galantamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> in the CNS</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bethanechol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct-acting <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> at <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors, promoting smooth muscle <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> and increasing <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> motility</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Physostigmine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> at both the central and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> nervous system, leading to increased <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> levels and enhanced <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> transmission</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ifbMM1ErgEAC041uoOZo1747069126.mp3", "video": ""}, {"text": "A 30-year-old female with no significant medical history presents to the clinic with complaints of intermittent shortness of breath and wheezing over the past few months. Her physical examination and baseline spirometry are unremarkable. The physician decides to perform a methacholine challenge test. Which of the following best describes the purpose of the methacholine challenge test?", "options": [{"label": "A", "text": "To confirm the presence of chronic obstructive pulmonary disease (COPD)", "correct": false}, {"label": "B", "text": "To diagnose pulmonary embolism", "correct": false}, {"label": "C", "text": "To identify airway hyperreactivity consistent with asthma", "correct": true}, {"label": "D", "text": "To assess for restrictive lung disease", "correct": false}], "correct_answer": "C. To identify airway hyperreactivity consistent with asthma", "question_images": [], "explanation_images": [], "explanation": "\n<p><strong>Educational Objective:</strong></p>\n<ul><li>➤ Learning Objective:</li><li>➤ The methacholine challenge test assesses airway hypersensitivity, a hallmark of asthma, by administering nebulised methacholine and measuring lung function changes.</li><li>➤ Positive: 20% decrease in FEV1 (PC20) at a concentration ≤ 4 mg/mL Asthma Intermediate: PC20 between 4-16 mg/mL Mild hyperreactivity Negative: PC20 &gt; 16 mg/mL Rules out asthma</li><li>➤ Positive: 20% decrease in FEV1 (PC20) at a concentration ≤ 4 mg/mL Asthma</li><li>➤ Positive: 20% decrease in FEV1 (PC20) at a concentration ≤ 4 mg/mL</li><li>➤ Positive: 20% decrease in FEV1 (PC20) at a concentration ≤ 4 mg/mL</li><li>➤ Intermediate: PC20 between 4-16 mg/mL Mild hyperreactivity</li><li>➤ Intermediate: PC20 between 4-16 mg/mL</li><li>➤ Intermediate: PC20 between 4-16 mg/mL</li><li>➤ Mild hyperreactivity</li><li>➤ Mild hyperreactivity</li><li>➤ Negative: PC20 &gt; 16 mg/mL Rules out asthma</li><li>➤ Negative: PC20 &gt; 16 mg/mL</li><li>➤ Negative: PC20 &gt; 16 mg/mL</li><li>➤ Rules out asthma</li><li>➤ Rules out asthma</li></ul>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:485px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Positive: 20% decrease in FEV1 (PC20) at a concentration ≤ 4 mg/mL</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Asthma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate: PC20 between 4-16 mg/mL</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild hyperreactivity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Negative: PC20 &gt; 16 mg/mL</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rules out asthma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cPvAWYOyE6o4m87zpNMa1747127702.mp3", "video": ""}, {"text": "A 6-year-old girl is brought to the emergency department by her parents after they found her unresponsive. They report that her younger sister sprayed the patient with a bottle filled with pesticide. On examination, the patient is lethargic and salivating. The patient’s blood pressure is 110/60 mm Hg, pulse is 58/min, and respirations are 42/min. Which of the following medications should be administered first during treatment of this patient's current condition?", "options": [{"label": "A", "text": "Neostigmine", "correct": false}, {"label": "B", "text": "Pralidoxime", "correct": false}, {"label": "C", "text": "Naloxone", "correct": false}, {"label": "D", "text": "Atropine", "correct": true}], "correct_answer": "D. Atropine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:561px\">\n<thead>\n<tr>\n<th colspan=\"2\" scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Organophosphate poisoning</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common exposures</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pesticide: farmer/field worker, <span class=\"customMeta\" data-dictid=\"318e52e4751692777195acbcdf4551\">pediatric</span> ingestion, suicide attempt</p>\n<p>Nerve agent: multiple patients presenting with similar symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Manifestations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscarinic <strong>(DUMBBELSS) :</strong></p>\n<ol>\n<li><strong>D-</strong>Diarrhea</li>\n<li><strong>U-</strong>Urination</li>\n<li><strong>M-</strong>Miosis</li>\n<li><strong>B-</strong>Bronchospasms, bronchorrhea, bradycardia</li>\n<li><strong>E-</strong>Excitation, Emesis</li>\n<li><strong>L-</strong>Lacrimation</li>\n<li><strong>S-</strong>Salivation, sweating</li>\n</ol>\n<p>Nicotinic:</p>\n<ol>\n<li>Muscle weakness, paralysis, fasciculations.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Management</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Decontamination</li>\n<li>Atropine reverses <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> symptoms</li>\n<li>Pralidoxime reverses <span class=\"customMeta\" data-dictid=\"c10496dcc416927771937d7280d782\">nicotinic</span> and <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> symptoms (reactivates cholinesterase)</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eDGIE90ecYFjuQfNnFdl1747127540.mp3", "video": ""}, {"text": "A 25-year-old male is undergoing a surgical procedure requiring general anesthesia. The anesthetic is administered. Shortly after administration, the patient experiences prolonged muscle paralysis, necessitating mechanical ventilation. Laboratory tests reveal a deficiency in pseudocholinesterase activity. Which of the following drugs is not responsible for the patient's prolonged muscle paralysis?", "options": [{"label": "A", "text": "Mivacurium", "correct": false}, {"label": "B", "text": "Succinylcholine", "correct": false}, {"label": "C", "text": "Rocuronium", "correct": true}, {"label": "D", "text": "Butyrylcholine", "correct": false}], "correct_answer": "C. Rocuronium", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YL8ZIVtbeJcnlc18eLB31747070925.mp3", "video": ""}, {"text": "Which of the following symptoms is seen in Atropine poisoning?", "options": [{"label": "A", "text": "Miosis", "correct": false}, {"label": "B", "text": "Mydriasis", "correct": true}, {"label": "C", "text": "Bronchospasm", "correct": false}, {"label": "D", "text": "Sweating", "correct": false}], "correct_answer": "B. Mydriasis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cholinergic symptoms</strong> (DUMBELS)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticholinergic symptoms</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diarrhea</li>\n<li>Urination</li>\n<li>Miosis <strong>(Option A)</strong></li>\n<li>Bronchospasm <strong>(Option C)</strong>, bradycardia, bronchorrhea</li>\n<li>Excitation/ seizures, Emesis</li>\n<li>Lacrimation</li>\n<li>Salivation, <span class=\"customMeta\" data-dictid=\"8fab5233721692777199fc0bcd1210\">Sweating</span> <strong>(Option D)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Constipation</li>\n<li>Urinary retention</li>\n<li>Mydriasis <strong>(Option B)</strong></li>\n<li>Tachycardia</li>\n<li>Hallucinations</li>\n<li>Delirium</li>\n<li>Seizures</li>\n<li>Dry eyes</li>\n<li>Dry mouth</li>\n<li>Decreased sweating</li>\n<li>Vasodilation (flushed skin)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2Jz06PAMLmK1PfENLDvm1747070737.mp3", "video": ""}, {"text": "A 45-year-old woman presents to her healthcare provider with complaints of severe dry mouth following radiation therapy for head and neck cancer. The physician prescribes a directly acting cholinergic drug to stimulate her salivary glands. Which of the following drugs is most appropriate for treating her condition?", "options": [{"label": "A", "text": "Carbachol", "correct": false}, {"label": "B", "text": "Bethanechol", "correct": false}, {"label": "C", "text": "Pilocarpine", "correct": true}, {"label": "D", "text": "Methacholine", "correct": false}], "correct_answer": "C. Pilocarpine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:679px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Amides/Alkaloids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical significance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pilocarpine</strong><br/>\n<strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pilocarpine <span class=\"customMeta\" data-dictid=\"eef118d8f31692777189e54df45163\">hydrochloride</span> is used to treat <span class=\"customMeta\" data-dictid=\"a39dfbc248169277720287ef893782\">xerostomia</span> that develops after head and neck radiation treatments or that is <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to <span class=\"customMeta\" data-dictid=\"e6fe6e6ccc16927771983f3bce9052\">Sjögren syndrome</span> and impairs their ability to <span class=\"customMeta\" data-dictid=\"7b8c92219216927771981950fdd0e8\">secrete</span> secretions (saliva and lacrimal), used for treatment of angle <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> glaucoma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cevimeline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cevimeline primarily stimulates the M1 and M3 receptors.<br/>\n\t\t\tCompared to pilocarpine, cevimeline may have fewer adverse effects and a long-lasting <span class=\"customMeta\" data-dictid=\"45071510e91692777198a3d92b5350\">sialogogic</span> impact on the salivary and <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> glands.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Choline esters</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Clinical significance</strong></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acetylcholine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACh is used topically as a 1% solution into the eye to induce <span class=\"customMeta\" data-dictid=\"cacca0f20e169277719222049c80a2\">miosis</span> during surgery, while it is rarely administered systemically.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methacholine (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhaling <span class=\"customMeta\" data-dictid=\"63fec808dd16927771921a8c8b7a03\">methacholine</span> can diagnose bronchial <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> <span class=\"customMeta\" data-dictid=\"05d473885c1692777189fe284131d7\">hyperreactivity</span> in patients without <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bethanechol (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GI and <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tracts are the main organs affected by bethanechol.<br/>\n\t\t\tBethanechol is useful for treating postop <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> retention, <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"bd1c98736616927771820954b0a744\">autonomic</span> neuropathy, and other chronic hypotonic, myogenic, or <span class=\"customMeta\" data-dictid=\"fec88fc386169277719326fdef547f\">neurogenic</span> <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> conditions when the organic <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> is absent. It can also be used to treat insufficient <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> emptying.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbachol </strong><br/>\n<strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carbachol is <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> into the eye as a 0.01% to 3% solution and is used topically in <span class=\"customMeta\" data-dictid=\"b0355c2c701692777194797cca9fac\">ophthalmology</span> to treat <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> and induce <span class=\"customMeta\" data-dictid=\"cacca0f20e169277719222049c80a2\">miosis</span> during surgery.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2c6CT1UrjdNhYpicp1CI1747070592.mp3", "video": ""}, {"text": "A 60-year-old male patient presents with urinary retention following abdominal surgery. The physician prescribes a drug that will stimulate bladder contraction by directly activating muscarinic receptors. Which of the following drugs is most appropriate for this condition?", "options": [{"label": "A", "text": "Bethanechol - Direct-acting cholinergic agonist", "correct": true}, {"label": "B", "text": "Neostigmine - Direct-acting anticholinergic", "correct": false}, {"label": "C", "text": "Atropine - Indirect-acting cholinergic agonist", "correct": false}, {"label": "D", "text": "Pilocarpine - Indirect-acting anticholinergic", "correct": false}], "correct_answer": "A. Bethanechol - Direct-acting cholinergic agonist", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/QCV685PAyo588VXU5itt1734420418.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pDznBqKd038xSurmK8sK1747070445.mp3", "video": ""}, {"text": "A 45 y/o male presents with severe abdominal pain, excessive salivation, sweating, bradycardia (heart rate 48 bpm), and miosis after ingesting an unknown substance. His blood pressure is 100/60 mmHg. Which muscarinic receptor type is primarily responsible for the observed bradycardia?", "options": [{"label": "A", "text": "M1 receptor", "correct": false}, {"label": "B", "text": "M2 receptor", "correct": true}, {"label": "C", "text": "M3 receptor", "correct": false}, {"label": "D", "text": "M4 receptor", "correct": false}], "correct_answer": "B. M2 receptor", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:732px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>CNS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M1, M2, M3, M4, M5</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Effects on cognitive function, motor control, <span class=\"customMeta\" data-dictid=\"d4a253810c1692777181f708ba3dc6\">appetite</span> regulation, nociception.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Autonomic ganglia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Modulates <span class=\"customMeta\" data-dictid=\"c10496dcc416927771937d7280d782\">nicotinic</span> actions of acetylcholine; may induce a long-lasting late EPSP.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Eye</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Iris: Pupillary <span class=\"customMeta\" data-dictid=\"4880e9b3761692777185e64eba797c\">constriction</span> (miosis).</li>\n<li>Ciliary muscle: <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">Contraction</span> (accommodation for near vision).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Glands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> from salivary, tracheobronchial, lacrimal, and sweat glands.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Heart</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>SA node: Decreases heart rate (negative <span class=\"customMeta\" data-dictid=\"59e3d661b51692777184a2d67aec94\">chronotropic</span> effect).</li>\n<li>AV node: Decreases <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> <span class=\"customMeta\" data-dictid=\"12c4510e191692777201c23ec126a3\">velocity</span> (negative <span class=\"customMeta\" data-dictid=\"db31e2bc88169277718669c177e180\">dromotropic</span> effect).</li>\n<li>Atrium: Shortening of <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> duration, decreased contractility.</li>\n<li>Ventricle: Decreased contractility.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Blood vessels</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Vasodilation (mediated through the release of <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> from endothelial cells)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Smooth muscle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Gastrointestinal tract: Increased tone and peristalsis, <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> relaxation.</li>\n<li>Urinary tract: <span class=\"customMeta\" data-dictid=\"80d318a6701692777186805934d86a\">Detrusor</span> muscle contraction, <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> <span class=\"customMeta\" data-dictid=\"d89806ebbe1692777200b7b677e616\">trigone</span> and <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> relaxation.</li>\n<li>Bronchial muscles: Constriction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Gastric glands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>M1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Stimulates <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> release, acid secretion</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uCsBHXOa7CbR1qBVvyrb1747070319.mp3", "video": ""}, {"text": "A 35-year-old man is admitted to the hospital with symptoms of muscle weakness, fasciculations, and myotonic jerks. The patient has a history of smoking and has been taking a cholinesterase inhibitor for a recent injury. The treating physician suspects that the patient's symptoms are due to the effects of the cholinesterase inhibitor. Which of the following receptors is most likely involved in the patient's symptoms?", "options": [{"label": "A", "text": "N M Receptors", "correct": true}, {"label": "B", "text": "M 3 Receptors", "correct": false}, {"label": "C", "text": "N n Receptors", "correct": false}, {"label": "D", "text": "Adrenergic receptors", "correct": false}], "correct_answer": "A. N M Receptors", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:669px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>N<sub>M</sub> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>N<sub>N</sub> (Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Location and function subserved</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neuromuscular Junction:</p>\n<p>Depolarization of muscle end plate-contraction of skeletal muscle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Autonomic ganglia: Depolarization</p>\n<p>-postganglionic impulse</p>\n<p>Adrenal medulla: <span class=\"customMeta\" data-dictid=\"69ccfc60d016927771837a12cdddb2\">catecholamine</span> release</p>\n<p>CNS: site specific <span class=\"customMeta\" data-dictid=\"8265e091151692777187f264d73f3b\">excitation</span> or inhibition</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nature</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Has <span class=\"customMeta\" data-dictid=\"a6795c876e169277719057a1099465\">Intrinsic</span> <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> channel, <span class=\"customMeta\" data-dictid=\"b09c0b2691169277719571dc62f699\">pentamer</span> of 𝛂<sub>2 </sub>, 𝜷, 𝛾 or 𝝴 and 𝜹 subunits</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Has <span class=\"customMeta\" data-dictid=\"a6795c876e169277719057a1099465\">intrinsic</span> <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> channel, pentamer</p>\n<p>of only 𝛂 or 𝛂𝜷 subunits</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Transducer mechanism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opening of <span class=\"customMeta\" data-dictid=\"299c6a693916927771832f0615b65d\">cation</span> (Na+ K+) channels</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opening of <span class=\"customMeta\" data-dictid=\"299c6a693916927771832f0615b65d\">cation</span> (Na+, K+, Ca2+) channels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Agonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenyl trimethyl <span class=\"customMeta\" data-dictid=\"3719e878a4169277718109b2d3f67e\">ammonium</span> (PTMA), Nicotine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dimethylphenylpiperazinium (DMPP), Nicotine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antagonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tubocurarine, 𝛂-Bungarotoxin, Atracurium, Vecuronium</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hexamethonium, Trimethaphan, Mecamylamine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qXo8IetoUxikbn4uPMVL1747069825.mp3", "video": ""}, {"text": "Which of the following statements regarding botulinum toxin (botox) is correct?", "options": [{"label": "A", "text": "Botox stimulates the release of Ach", "correct": false}, {"label": "B", "text": "Botox type B is more effective than type A", "correct": false}, {"label": "C", "text": "Botox injection causes muscle relaxation", "correct": true}, {"label": "D", "text": "Onabotulinumtoxin A is used to treat dry mouth", "correct": false}], "correct_answer": "C. Botox injection causes muscle relaxation", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ndzEcfzd7iNY1jPsi0ps1747069673.mp3", "video": ""}, {"text": "A 72-year-old patient presents with symptoms of memory loss and confusion. After a thorough evaluation, the patient is diagnosed with Alzheimer's disease. The physician prescribes a medication that inhibits the enzyme acetylcholinesterase, available as a transdermal patch. Which of the following drugs is most likely to be prescribed?", "options": [{"label": "A", "text": "Tacrine", "correct": false}, {"label": "B", "text": "Donepezil", "correct": false}, {"label": "C", "text": "Rivastigmine", "correct": true}, {"label": "D", "text": "Memantine", "correct": false}], "correct_answer": "C. Rivastigmine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:928px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CHOLINERGICS</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anticholinesterases are the first-line drugs.</li>\n<li>Mechanism of action: They are <span class=\"customMeta\" data-dictid=\"22e8a6f65016927772003e97740ab2\">tertiary</span> amines, inhibiting <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> esterase, increasing <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> levels, and improving memory.</li>\n<li>Drugs:\n\t\t\t\t<ul>\n<li><strong>Tacrine (Option A):</strong> Not preferred/obsolete due to hepatotoxicity.</li>\n<li>Other drugs:</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Donepezil (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rivastigmine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Galantamine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enzymes inhibited</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>AChE</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>AChE, BuChE</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>AChE</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Noncompetitive</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Noncompetitive</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Typical maintenance dose</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10 mg once daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>9.5 mg/24 h (transdermal)</p>\n<p>3-6 mg twice daily (oral)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>8-12 mg twice daily (immediate release)</p>\n<p>16-24 mg/d (extended-release)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>FDA-approved indications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild-severe AD</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild-moderate AD</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild-moderate AD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2D6</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Esterases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2D6, CYP3A4</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Note:</strong></p>\n<ul>\n<li>Acetylcholinesterase (AChE) is the major <span class=\"customMeta\" data-dictid=\"aefa9aaa9216927771841998c2c30a\">cholinesterase</span> in the brain; butyrylcholinesterase (BuChE) is a <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> and <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> <span class=\"customMeta\" data-dictid=\"aefa9aaa9216927771841998c2c30a\">cholinesterase</span> that is upregulated in AD brain.</li>\n<li>Typical starting doses are one-half of the <span class=\"customMeta\" data-dictid=\"c673060f4c16927771917496b672c8\">maintenance dose</span> and are given for the first month of therapy.</li>\n<li>Donepezil: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for AD as it is the longest-acting and most effective.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NMDA ANTAGONIST</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Memantine (Option D).</strong></li>\n<li>For severe <span class=\"customMeta\" data-dictid=\"41cc5ad93c169277718553c6b948a3\">dementia</span> (uncontrolled by anticholinesterases).</li>\n<li>Increases memory.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ANTI-𝛃-AMYLOID <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">MONOCLONAL</span> ANTIBODIES</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>For severe <span class=\"customMeta\" data-dictid=\"41cc5ad93c169277718553c6b948a3\">dementia</span> (uncontrolled by anticholinesterases).</li>\n<li><strong>Aducanumab:</strong> Blocks fibrils.</li>\n<li><strong>Lecanemab:</strong> Blocks protofibrils.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MISCELLANEOUS</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Not FDA approved.</li>\n<li>Memory enhancers.</li>\n<li>Piribedil.</li>\n<li>Piracetam.</li>\n<li>Pyritinol (Pyrithroxine).</li>\n<li>Citicoline.</li>\n<li>Gingko biloba.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/38l42qchTIURO5zBvrAa1747069244.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 33 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 34-year-old male presents with symptoms of acute onset blurred vision, dry mouth, tachycardia, and urinary retention. His medical history is unremarkable, and he denies any recent illnesses or medication use. On examination, his pupils are dilated and unreactive to light. Which of the following is the most likely cause of his presentation?", "options": [{"label": "A", "text": "Cocaine toxicity", "correct": false}, {"label": "B", "text": "Opioid overdose", "correct": false}, {"label": "C", "text": "Benzodiazepine intoxication", "correct": false}, {"label": "D", "text": "Atropine poisoning", "correct": true}], "correct_answer": "D. Atropine poisoning", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/P8pjGOyc32e4RveOvIbs1747130170.mp3", "video": ""}, {"text": "A 30-year-old woman presents with nausea, dizziness, and vomiting after travelling by boat during a recent vacation. She reports these symptoms occur whenever she is in motion, particularly when sailing or driving on winding roads. The patient states that her symptoms significantly interfere with her ability to enjoy travel and have become increasingly bothersome over time. She is prescribed a patch for her condition. Which is the drug of choice?", "options": [{"label": "A", "text": "Hyoscine", "correct": true}, {"label": "B", "text": "Acetazolamide", "correct": false}, {"label": "C", "text": "Meclizine", "correct": false}, {"label": "D", "text": "Diphenhydramine", "correct": false}], "correct_answer": "A. Hyoscine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TJluQWePdbbEA9DImwZ01747130299.mp3", "video": ""}, {"text": "Which of the following statements is false?", "options": [{"label": "A", "text": "Atropine causes delirium", "correct": false}, {"label": "B", "text": "Hyoscine is used as a truth serum", "correct": false}, {"label": "C", "text": "Hyoscine does not cause sedation", "correct": true}, {"label": "D", "text": "Atropine is used to treat AV node block", "correct": false}], "correct_answer": "C. Hyoscine does not cause sedation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CNS Penetration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CNS Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Atropine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High doses → <strong>delirium</strong>, hallucinations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bradycardia, AV block, <span class=\"customMeta\" data-dictid=\"505a21f8451692777194a113951c68\">organophosphate</span> poisoning</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyoscine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sedation, amnesia, motion sickness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Motion sickness, pre-anesthetic, “truth serum”</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glycopyrrolate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used as <span class=\"customMeta\" data-dictid=\"754347dbea1692777196fbe8206893\">premedication</span> to reduce secretions without sedation</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Atropine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyoscine (Scopolamine)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Source: <span class=\"customMeta\" data-dictid=\"1790d285a0169277718273751e8d88\">Atropa</span> belladona, <span class=\"customMeta\" data-dictid=\"294737a01816927771855e9883e9e8\">Datura</span> stramonium</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Source: <span class=\"customMeta\" data-dictid=\"d2e095fe1816927771892a5274460c\">Hyoscyamus</span> niger</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes excitation, seizures</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes <span class=\"customMeta\" data-dictid=\"b81cee1b5f16927771987099f651a0\">sedation</span> (calm and sleepy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less effective <span class=\"customMeta\" data-dictid=\"fe1a980b121692777182f88db01254\">BBB</span> penetration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Better <span class=\"customMeta\" data-dictid=\"fe1a980b121692777182f88db01254\">BBB</span> penetration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC for OPC and <span class=\"customMeta\" data-dictid=\"1c84f47ead169277718314715645dd\">carbamate</span> poisoning</li>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> and AV block</li>\n<li>Preferred <span class=\"customMeta\" data-dictid=\"fbf4efea93169277718581f1bf67f0\">cycloplegic</span> in children</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used as a truth serum</li>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of motion sickness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases memory and <span class=\"customMeta\" data-dictid=\"66a72871741692777184da29e3ed5d\">cognition</span> (C/I in Alzheimer's disease)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XCvrSyv4smRhfoIKP70S1747130465.mp3", "video": ""}, {"text": "A 65-year-old woman with schizophrenia, treated with haloperidol, develops worsening tremors and stiffness. She exhibits bradykinesia, rigidity, and resting tremor, suggestive of parkinsonism. To manage these symptoms, she is prescribed an anticholinergic. Which of the following is not typically an anticholinergic drug but still used for this purpose?", "options": [{"label": "A", "text": "Benzhexol", "correct": false}, {"label": "B", "text": "Benztropine", "correct": false}, {"label": "C", "text": "Bipyridine", "correct": false}, {"label": "D", "text": "Promethazine", "correct": true}], "correct_answer": "D. Promethazine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qPNlFARLKi7Knjeh8LUI1747130697.mp3", "video": ""}, {"text": "A 67 Y/o male with a history of COPD and advanced Parkinson’s disease presents with severe sialorrhea, which significantly impacts his quality of life. The patient has tried multiple treatments, including atropine and scopolamine, with limited success. He is started on a trial of glycopyrrolate. Which of the following is true regarding glycopyrrolate?", "options": [{"label": "A", "text": "Glycopyrrolate crosses BBB and worsens Parkinson's disease", "correct": false}, {"label": "B", "text": "It is contraindicated in COPD as it may cause bronchospasm", "correct": false}, {"label": "C", "text": "It primarily acts on peripheral muscarinic receptors", "correct": true}, {"label": "D", "text": "It is short-acting, requiring multiple doses", "correct": false}], "correct_answer": "C. It primarily acts on peripheral muscarinic receptors", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DcHvdIlQhy5JR0r3ti3c1747130917.mp3", "video": ""}, {"text": "A 68-year-old male patient with COPD (GOLD stage 2) comes in for a regular check-up. His current medications include a short-acting beta2-agonist (SABA) as needed. Despite this treatment, he complained of frequent symptoms and two exacerbations in the last year that required oral corticosteroids. His spirometry shows an FEV1 of 60% predicted. Which of the following drugs can be added to help the patient further?", "options": [{"label": "A", "text": "Tiotropium", "correct": true}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Hyoscine", "correct": false}, {"label": "D", "text": "Trimipramine", "correct": false}], "correct_answer": "A. Tiotropium", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:547px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dosage frequency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipratropium</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Four times daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metered-dose <span class=\"customMeta\" data-dictid=\"302965be571692777190f632502628\">inhaler</span> or nebuliser</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aclidinium</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Twice daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dry powder inhaler</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tiotropium</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Once-daily</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dry powder <span class=\"customMeta\" data-dictid=\"302965be571692777190f632502628\">inhaler</span> (for maintenance therapy of moderate-to-severe disease)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Umeclidinium</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a5rsCEF0vlF4DwVWjDJM1747131994.mp3", "video": ""}, {"text": "A 45-year-old woman presents to the ophthalmology clinic for a routine eye examination. The ophthalmologist performs a detailed fundoscopic examination to assess the retina. To facilitate this, the ophthalmologist administers an eye drop that causes mydriasis. Which of the following medications is most likely used for this purpose?", "options": [{"label": "A", "text": "Atropine", "correct": false}, {"label": "B", "text": "Tropicamide", "correct": true}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Timolol", "correct": false}], "correct_answer": "B. Tropicamide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticholinergic Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Therapeutic Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atropine<br/>\n<strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Long-lasting <span class=\"customMeta\" data-dictid=\"d37f6ac51016927771932ba05a49bc\">mydriasis</span> and <span class=\"customMeta\" data-dictid=\"fade1f28fd16927771855eb362548f\">cycloplegia</span> (3-5 days); hence not used in adults</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used in treating iritis, iridocyclitis, choroiditis, keratitis, and corneal ulcer</li>\n<li>Helps to decrease <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> muscles &amp; reduce spasms</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Homatropine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Semi-synthetic <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">atropine</span> derivative, shorter duration than atropine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used in the treatment of uveitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclopentolate Hydrochloride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potent, rapid-acting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used for <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error testing</li>\n<li>Used in the treatment of uveitis</li>\n<li>Preferred <span class=\"customMeta\" data-dictid=\"fbf4efea93169277718581f1bf67f0\">cycloplegic</span> in children (may cause <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> behavioral changes in children due to <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> absorption)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tropicamide <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Short-acting, fast onset, less reliable cycloplegic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Preferred <span class=\"customMeta\" data-dictid=\"fbf4efea93169277718581f1bf67f0\">cycloplegic</span> in adults</li>\n<li>Used as a short-acting <span class=\"customMeta\" data-dictid=\"f0b2e624c316927771930c98e09c8d\">mydriatic</span> for fundoscopy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyoscine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Similar <span class=\"customMeta\" data-dictid=\"fbf4efea93169277718581f1bf67f0\">cycloplegic</span> action to atropine, more potent mydriatic, long duration but shorter than atropine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Useful for relieving pain in <span class=\"customMeta\" data-dictid=\"5d80cc9ebc16927771907b9a2d7dc5\">iridocyclitis</span> due to <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle spasm</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DKGyrMIYSqUdXDZCayeA1747132178.mp3", "video": ""}, {"text": "A 78-year-old female patient with a known diagnosis of Alzheimer's disease presents to the geriatric clinic with complaints of urinary urgency, frequency, and urge incontinence for the past six months. She is currently taking donepezil for Alzheimer's disease. Which of the following medications is most appropriate for managing this patient's urinary symptoms?", "options": [{"label": "A", "text": "Oxybutynin", "correct": false}, {"label": "B", "text": "Trospium", "correct": true}, {"label": "C", "text": "Solifenacin", "correct": false}, {"label": "D", "text": "Mirabegron", "correct": false}], "correct_answer": "B. Trospium", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:686px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CHOLINERGIC DRUGS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ANTICHOLINERGIC DRUGS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Action: Detrusor contraction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Action: Block M3 receptors → Detrusor relaxation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Bethanechol</li>\n<li>Neostigmine</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non Selective M3 blockers:</p>\n<ol>\n<li>Trospium</li>\n<li>Oxybutynin<strong>(Option A)</strong></li>\n<li>Fesoterodine</li>\n<li>Flavoxate</li>\n</ol>\n\t\t\t \n\n\t\t\t<p>Selective M3 Blockers:</p>\n<ol>\n<li>Solifenacin <strong>(Option C)</strong></li>\n<li>Darifenacin</li>\n<li>Tolterodine</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses: <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">Bladder</span> <span class=\"customMeta\" data-dictid=\"d4d4e36d2416927771828288897bf3\">atony</span> (overflow incontinence)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses: OAB (urge incontinence)</p>\n<ul>\n<li>Detrusor overactivity</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> capacity</li>\n<li>Reduced frequency of <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> contractions</li>\n<li>Suppression of the urge to urinate</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:699px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta 3 agonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha 1 activator</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Site: Detrusor</p>\n<p>Action: Relaxation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Site: Internal <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> sphincter</p>\n<p>Action: <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">Sphincter</span> contraction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Mirabegron <strong>(Option D)</strong></li>\n<li>Vibegron</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Duloxetine (SNRI): Increased <span class=\"customMeta\" data-dictid=\"76baf6616a169277718738f8790ab9\">epinephrine</span> availability → 𝛂1 stimulation</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses: Urge incontinence</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses: Stress incontinence</p>\n<ul>\n<li>Urethral <span class=\"customMeta\" data-dictid=\"c9496b2dce16927771894c770c43d9\">hypermobility</span> or <span class=\"customMeta\" data-dictid=\"a6795c876e169277719057a1099465\">intrinsic</span> <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> causes leaks with increased <span class=\"customMeta\" data-dictid=\"b02812a466169277719090c2d27868\">intra-abdominal</span> pressure</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pOzEMqZh6bslGdGPG3Y61747132395.mp3", "video": ""}, {"text": "A 36-year-old woman presents with severe cramping abdominal pain and nausea. She reports that the pain started abruptly a few hours ago and is associated with bloating and diarrhea. She has a history of irritable bowel syndrome (IBS), and similar episodes have occurred in the past. Which of the following medications is most appropriate for relieving her symptoms?", "options": [{"label": "A", "text": "Telenzepine", "correct": false}, {"label": "B", "text": "Scopolamine", "correct": true}, {"label": "C", "text": "Hexamethonium", "correct": false}, {"label": "D", "text": "Thiopentone", "correct": false}], "correct_answer": "B. Scopolamine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/n5BCfsl6soHBnn74P7nl1734420758.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qpNdK7j1RGBLXO0XKCzr1747132604.mp3", "video": ""}, {"text": "A 9-year-old girl is brought to the pediatrician for frequent, forceful eye blinking and throat clearing, especially when anxious or excited. These brief episodes occur multiple times per hour. She was diagnosed and started on a ganglionic blocker to manage tics. Which of the following could be the possible side effects of the drug?", "options": [{"label": "A", "text": "Bradycardia", "correct": false}, {"label": "B", "text": "Urinary incontinence", "correct": false}, {"label": "C", "text": "Increased salivation", "correct": false}, {"label": "D", "text": "Orthostatic hypotension", "correct": true}], "correct_answer": "D. Orthostatic hypotension", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>GANGLION BLOCKERS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Persistent depolarising blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nicotine (Large doses)</li>\n<li>Anticholinesterases (Large doses)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Competitive blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Trimethaphan:\n\t\t\t\t<ul>\n<li>Competes with <span class=\"customMeta\" data-dictid=\"fba05f424716927771802b63f6c392\">Ach</span> at NMJ. <span class=\"customMeta\" data-dictid=\"dca0ba73c21692777181cf110912d6\">Analogous</span> to the MOA of <span class=\"customMeta\" data-dictid=\"168e0ebd2516927771855e73989906\">curare</span> at the NMJ</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> related to a dissecting aortic aneurysm, as it helps block the sympathetically mediated increase in <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> velocity, which is beneficial</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Channel blockers</strong> (Blocks Nn <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> after the channel opens, shortening the current flow duration by occluding or closing the channel)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hexamethonium: Used to treat <span class=\"customMeta\" data-dictid=\"dd2daa0c6216927771893c9cab82d9\">hypertensive</span> emergencies (no longer in use)</li>\n<li>Mecamylamine:\n\t\t\t\t<ul>\n<li>Used in <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> <span class=\"customMeta\" data-dictid=\"01be542e8e16927771861e861ab536\">dependence</span> to reduce <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings (Used in <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> with nicotine)</li>\n<li>Used in Mx of <span class=\"customMeta\" data-dictid=\"60a6822813169277720010b1be234a\">Tourette</span> syndrome</li>\n<li>As an <span class=\"customMeta\" data-dictid=\"a9952795951692777181001d03753a\">antihypertensive</span> for moderate to severe HTN</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:719px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>EFFECTS ON <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">GANGLION</span> <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">BLOCKADE</span> ON ORGAN SYSTEMS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Organ System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effect of blockade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Blockade of the dominant tone</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">CVS<br/>\n<strong>(Option A ruled out) (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Heart: Tachycardia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Parasympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Blood vessels: Vasodilatation, postural <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> due to decreased <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> return</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">GIT <strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Decreased motility, constipation, and dry mouth</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Parasympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Urinary bladder<br/>\n<strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Urinary retention</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Parasympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Eye</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Mydriasis (pupil dilation) and <span class=\"customMeta\" data-dictid=\"fade1f28fd16927771855eb362548f\">cycloplegia</span> (paralysis of accommodation).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Parasympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sweat glands</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Anhydrosis (decreased sweating)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sympathetic blockade</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Male sexual function</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Inability to maintain erection</p>\n<p style=\"text-align: center;\">Inhibition of ejaculation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sympathetic and <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">Parasympathetic</span> blockade</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zxSYE2Ve4wOrDuWSKsrW1747132774.mp3", "video": ""}, {"text": "A 43-year-old Man presents with increased mouth secretions, mild respiratory difficulty, and a heart rate of 52 bpm after eating sushi. While being examined, the patient loses consciousness. The patient is given atropine. Which of the following describes the action of atropine on heart rate?", "options": [{"label": "A", "text": "Tachycardia", "correct": false}, {"label": "B", "text": "Initial tachycardia followed by bradycardia", "correct": false}, {"label": "C", "text": "Initial bradycardia followed by tachycardia", "correct": true}, {"label": "D", "text": "Worsens bradycardia", "correct": false}], "correct_answer": "C. Initial bradycardia followed by tachycardia", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Usi1S9TQrZ1Wa9MDh87e1734420807.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RXemDNhSGAkS3aUu4St71747132939.mp3", "video": ""}, {"text": "A 67-year-old male patient with a known history of primary open-angle glaucoma presents to the clinic for a routine eye examination. He reports no new symptoms, and his intraocular pressure (IOP) has been well controlled. Which of the following medications is preferred in this patient for dilating the pupils?", "options": [{"label": "A", "text": "Atropine", "correct": false}, {"label": "B", "text": "Phenylephrine", "correct": true}, {"label": "C", "text": "Homatropine", "correct": false}, {"label": "D", "text": "Cyclopentolate", "correct": false}], "correct_answer": "B. Phenylephrine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ocular side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Atropine</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Cycloplegia, mydriasis, iritis, uveitis</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Photosensitivity, blurred vision, open-angle glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Homatropine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Cyclopentolate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Cycloplegiaa, mydriasis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Photosensitivity, blurred vision, open-angle glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Phenylephrine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Mydriasis, vasoconstriction, uveitis, glaucoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\">Acts for several hours</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QYBoEEi6HKKegarlYYGK1747150694.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs exacerbates myasthenia and is usually avoided in a patient with myasthenia gravis? Lidocaine Digene Meropenem Phenytoin", "options": [{"label": "A", "text": "1 &amp;amp; 2", "correct": true}, {"label": "B", "text": "2 &amp;amp; 3", "correct": false}, {"label": "C", "text": "1 &amp;amp; 3", "correct": false}, {"label": "D", "text": "1 only", "correct": false}], "correct_answer": "A. 1 &amp; 2", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - 1 &amp;amp; 2\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Dopamine at low doses causes:", "options": [{"label": "A", "text": "Increases in cardiac contractility", "correct": false}, {"label": "B", "text": "Vasoconstriction", "correct": false}, {"label": "C", "text": "Tachycardia", "correct": false}, {"label": "D", "text": "Increases renal blood flow", "correct": true}], "correct_answer": "D. Increases renal blood flow", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Increases &lt;span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\"&gt;renal&lt;/span&gt; blood flow.</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Dopamine Dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Receptor Activation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>&lt; 2 µg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>D1 receptors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> blood flow; <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> and mesenteric vessels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>2-10 µg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>β1 receptors (heart)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>Increases heart rate (positive chronotropic) and <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> (positive inotropy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>&gt; 10 µg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>α1 receptors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p>Vasoconstriction (increased <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> resistance) and increased blood pressure</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child, after disturbing a bee hive, experienced several stings. A few minutes later, the child developed breathing difficulty and hypotension. What is the drug of choice for managing this child?", "options": [{"label": "A", "text": "Dobutamine", "correct": false}, {"label": "B", "text": "Adrenaline", "correct": true}, {"label": "C", "text": "Noradrenaline", "correct": false}, {"label": "D", "text": "Dopamine", "correct": false}], "correct_answer": "B. Adrenaline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Adrenaline</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Uses of Epinephrine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Dilution/Concentration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Route of Administration</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Anaphylaxis</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>First-line treatment for severe allergic reactions</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intramuscular (IM)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Cardiac arrest</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>To restore <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> rhythm and blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:10,000 (0.1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intravenous (IV)</li>\n<li>Intraosseous (IO)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Asthma</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> severe <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> attacks</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Inhalation via nebulizer</li>\n<li>Intramuscular (IM)</li>\n<li>subcutaneous (SC)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Hypotension</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>To increase blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:100,000 (0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intravenous (IV) infusion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Local anesthesia</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Enhance duration and intensity of the local anaesthetic effect</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:200,000 to 1:100,000 (0.005 to 0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Local injection</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female presents with muscle weakness, blurred vision after exertion, and ptosis, which improves after undergoing the edrophonium test. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Lambert Eaton syndrome", "correct": false}, {"label": "B", "text": "Myasthenia gravis", "correct": true}, {"label": "C", "text": "Guillain-Barré syndrome", "correct": false}, {"label": "D", "text": "Bronchial asthma", "correct": false}], "correct_answer": "B. Myasthenia gravis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"6fa809ad22169277719323eaa30f1e\"&gt;Myasthenia&lt;/span&gt; grav\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the options below acts as a selective alpha-1 receptor antagonist in medical practice?", "options": [{"label": "A", "text": "Phenoxybenzamine", "correct": false}, {"label": "B", "text": "Phentolamine", "correct": false}, {"label": "C", "text": "Prazosin", "correct": true}, {"label": "D", "text": "Idazoxan", "correct": false}], "correct_answer": "C. Prazosin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Prazosin</p>\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"5\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Classification of Alpha-blockers based on their <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> binding</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Types</strong></p>\n</td>\n<td colspan=\"4\" rowspan=\"1\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Non-<br/>\n\t\t\tcompetitive + <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> type</strong></p>\n</td>\n<td colspan=\"4\" rowspan=\"1\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Phenoxybenzamine</strong></p>\n<p style=\"text-align: center;\"> </p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Competitive + <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> type</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-selective</strong></p>\n<p> </p>\n<p> </p>\n<p> </p>\n</td>\n<td colspan=\"3\" rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phentolamine</strong></p>\n<p>Ergotamine</p>\n<p>Ergotoxine</p>\n<p>Chlorpromazine</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Alpha 1 selective</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 1 a</strong></p>\n<p>Tamsulosin</p>\n<p>Silodosin</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Internal Urethral Sphincter</p>\n<p>Iris</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ejaculation failure/retrograde ejaculation, miosis, increased <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 1 b</strong></p>\n<p>Alfuzosin</p>\n<p>Doxazosin</p>\n<p><strong>Prazosin</strong></p>\n<p>Terazosin</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vascular Smooth Muscle</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vasodilatation, <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tachycardia, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"1c745475f51692777188c744487e6f\">GFR</span> (thus leading to <span class=\"customMeta\" data-dictid=\"15d91786931692777197c8932c8000\">RAAS</span> activation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 2 selective</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Yohimbine</strong></p>\n<p>Idoxazon</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Central Nervous System</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Penile <span class=\"customMeta\" data-dictid=\"322d94cd5816927771872f3d8d132b\">erection</span> (used in depression with sexual dysfunction)</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Prazosin is a highly selective ɑ1 blocker.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Postural <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> (first dose effect) - due to <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1b <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> on <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscles</li>\n<li>Retrograde ejaculation: Due to <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1a receptors <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> on internal urethral sphincter</li>\n<li>Floppy <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> syndrome: Due to the <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> of the <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> on the iris</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> occurs due to vasodilation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Benign prostatic hyperplasia</li>\n<li>Raynaud’s disease</li>\n<li>Scorpion Bite.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The dose at which dopamine acts on beta-1 receptors is _________?", "options": [{"label": "A", "text": "2-10 mcg/kg/min", "correct": true}, {"label": "B", "text": "&amp;lt;2 mcg/kg/min", "correct": false}, {"label": "C", "text": "10-20 mcg/kg/min", "correct": false}, {"label": "D", "text": "&amp;gt;20 mcg/kg/min", "correct": false}], "correct_answer": "A. 2-10 mcg/kg/min", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Different effects of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> based on dose</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Dose</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Effects</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>&lt;2 mcg/kg/min</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Stimulated D1 and D2 receptors, which increased <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> to the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> and mesenteric vessels</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>2-5 mcg/kg/min</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Dopamine acts on <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> beta-1 receptors, which increases myocardial contractility. It is also used during <span class=\"customMeta\" data-dictid=\"25ec593008169277718360336a849a\">cardiogenic</span> shock.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>5-15 mcg/kg/min</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Dopamine acts on alpha-1 receptors to increase <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> resistance.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the most effective drug in smoking cessation?", "options": [{"label": "A", "text": "Varenicline", "correct": true}, {"label": "B", "text": "Buspirone SR", "correct": false}, {"label": "C", "text": "Nicotine Gum", "correct": false}, {"label": "D", "text": "Rimonabant", "correct": false}], "correct_answer": "A. Varenicline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - V\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effect on Smoking Cessation</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>First-Line Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bupropion</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> and <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> in the brain</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nicotine Replacement Therapy (NRT)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Provides controlled <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> dose (patches, gum, lozenges, inhalers). Never given orally, <span class=\"customMeta\" data-dictid=\"75089cc39e1692777199b8933bd249\">sublingual</span> due to its fast absorption</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Alleviates <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings, gradually reducing <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> dependence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Varenicline</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Binds to <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> receptors in the brain, partially stimulating them.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Most effective drug.</p>\n<p>Reduces cravings and pleasurable effects of smoking.</p>\n<p>Used in tobacco chewing.<br/>\n\t\t\tS/E: Depression (suicides)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>All first-line drugs are C/I in seizures and heart diseases (MI, angina, hypertension)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Second-Line Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Clonidine<br/>\n\t\t\t </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Alpha-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> agonist, reduces <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> nervous system activity</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Alleviates <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> such as anxiety, irritability, and restlessness.</li>\n<li>Safe in patients with heart disease/seizure.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nortriptyline</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tricyclic antidepressant, affecting <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> and <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> levels</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reduces <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Topiramate</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors and facilitates <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> neurotransmission</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Potentially facilitates smoking cessation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mecamylamine</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> receptors in the brain</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reduces the rewarding effects of nicotine, making smoking less appealing.</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"ab7b0c22011692777193361d22130c\">nicotine</span> poisoning.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs can be used to treat open-angle glaucoma in a patient with bronchial asthma?", "options": [{"label": "A", "text": "Latanoprost", "correct": true}, {"label": "B", "text": "Timolol", "correct": false}, {"label": "C", "text": "Gemeprost", "correct": false}, {"label": "D", "text": "Mannitol infusion", "correct": false}], "correct_answer": "A. Latanoprost", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/FqbXqhbkITkqe4A9qYtp1746442697.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Latanoprost</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Alters <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle tension - improves <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humour outflow</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Advantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>High efficacy</li>\n<li>Once daily application only</li>\n<li>No <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> side effects</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Disadvantages </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Expensive</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Blurring of vision</li>\n<li>Iris pigmentation</li>\n<li>Thickening and darkening of eyelashes</li>\n<li>Macular <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (in aphakic patients )</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Drugs used in the management of <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs increasing trabecular outflow </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Miotics</li>\n<li>Dipivefrine, Epinephrine</li>\n<li>Bimatoprost</li>\n<li>Netarsidil</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs increasing uveoscleral outflow </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>PGF2α <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> - <strong>Latanoprost</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs decreasing <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humour production </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors - <strong>Acetazolamide </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hyperosmotic agents </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mannitol</li>\n<li>Urea</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with a history of multiple episodes of vomiting. He was given intravenous medication for the same. Later, he developed abnormal movements. Which of the following drugs can be used to treat him?", "options": [{"label": "A", "text": "Hyoscine", "correct": false}, {"label": "B", "text": "Cyprohepptadine", "correct": false}, {"label": "C", "text": "Levodopa", "correct": false}, {"label": "D", "text": "Benzhexol", "correct": true}], "correct_answer": "D. Benzhexol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:689px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Metoclopramide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dopamine <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist; acts centrally as a <span class=\"customMeta\" data-dictid=\"61274f971e1692777196235af20217\">prokinetic</span> and anti-emetic.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Extrapyramidal symptoms </strong>\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"61747121f116927771862fad303b93\">dystonia</span> - occurs shortly after IV injection</li>\n<li>Parkinson-like symptoms seen after weeks of therapy</li>\n<li>Irreversible <span class=\"customMeta\" data-dictid=\"d93ab38f5316927772001828e5e817\">tardive</span> <span class=\"customMeta\" data-dictid=\"aa971a0b1c169277718621174b6657\">dyskinesia</span> - occurs with chronic treatment</li>\n</ul>\n</li>\n<li>Galactorrhoea</li>\n<li>Methemoglobinemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management of <span class=\"customMeta\" data-dictid=\"e2952dfc311692777187fa773bcc9f\">extrapyramidal</span> symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Discontinuation of the drug.</li>\n<li><strong>Benzhexol</strong> - centrally acting <span class=\"customMeta\" data-dictid=\"9b4dbbb3321692777181e6fe172b88\">anticholinergic</span> agents.</li>\n<li>Restores <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> balance in the <span class=\"customMeta\" data-dictid=\"10dcc5831f169277719904802d9cad\">striatal</span> interneurons.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The response on stimulation of the muscarinic receptor is _", "options": [{"label": "A", "text": "Erection", "correct": true}, {"label": "B", "text": "Ejaculation", "correct": false}, {"label": "C", "text": "Bronchodilation", "correct": false}, {"label": "D", "text": "Increased myocardial contractility", "correct": false}], "correct_answer": "A. Erection", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - E\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications is most commonly used for maintenance therapy in opioid withdrawal?", "options": [{"label": "A", "text": "Buprenorphine", "correct": true}, {"label": "B", "text": "Naloxone", "correct": false}, {"label": "C", "text": "Naltrexone", "correct": false}, {"label": "D", "text": "Acamprosate", "correct": false}], "correct_answer": "A. Buprenorphine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Buprenorph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with diabetes developed postoperative urinary retention. Which of the following drugs can be used for short-term treatment of the condition?", "options": [{"label": "A", "text": "Tamsulosin", "correct": false}, {"label": "B", "text": "Bethanechol", "correct": true}, {"label": "C", "text": "Terazosin", "correct": false}, {"label": "D", "text": "Methacholine", "correct": false}], "correct_answer": "B. Bethanechol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Bethanechol</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bethanechol is a <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> that stimulates <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors, which are found primarily in the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> and <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> tracts.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mimics the effects of acetylcholine, which plays a crucial role in the <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">parasympathetic</span> nervous system, at <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors.</li>\n<li>Upon stimulating <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors, it promotes <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> muscle contraction, aiding in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> expulsion and reducing <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> retention.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Usage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Postoperative and <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">Postpartum</span> <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> with no actual obstruction.</li>\n<li>Neurogenic bladder.</li>\n<li>Symptomatic relief in <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> megacolon.</li>\n<li>Gastroesophageal reflux</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Gastrointestinal: Belching, <span class=\"customMeta\" data-dictid=\"42b110efe11692777190ea5720c867\">involuntary</span> defecation.</li>\n<li>Urinary: <span class=\"customMeta\" data-dictid=\"42b110efe11692777190ea5720c867\">Involuntary</span> urination.</li>\n<li>Other: Flushing, sweating, hypotension.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mechanical <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> or <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract.</li>\n<li>Asthma.</li>\n<li>Hypotension.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was prescribed an antipsychotic drug, following which he developed Parkinsonism. Which of the following drugs can be given?", "options": [{"label": "A", "text": "Trihexyphenidyl", "correct": true}, {"label": "B", "text": "Entacapone", "correct": false}, {"label": "C", "text": "Rasagiline", "correct": false}, {"label": "D", "text": "Pramipexole", "correct": false}], "correct_answer": "A. Trihexyphenidyl", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Trihexyph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Beta-blockers are ideally avoided in which of the following?", "options": [{"label": "A", "text": "Essential tremors", "correct": false}, {"label": "B", "text": "Diabetes mellitus with hypertension", "correct": true}, {"label": "C", "text": "Angina pectoris", "correct": false}, {"label": "D", "text": "Migraine prophylaxis", "correct": false}], "correct_answer": "B. Diabetes mellitus with hypertension", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"b6a934c67b16927771868fca92baf9\"&gt;Diabetes mellitus&lt;/span&gt; with hypertension</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses of beta-blockers</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug of choice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Migraine <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> <strong>(Option D)</strong></li>\n<li>Essential tremors <strong>(Option A)</strong></li>\n<li>Aortic <span class=\"customMeta\" data-dictid=\"e42da316b916927771860f0ba81c19\">dissection</span> if they also have hypertension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Other Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension-second-line drugs</li>\n<li>Stable angina: Decrease the frequency of attacks and increase exercise tolerance. <strong> (Option C)</strong></li>\n</ul>\n<ul>\n<li>Cardiac arrhythmias: Used in both <span class=\"customMeta\" data-dictid=\"619efd9f7b169277719928c9441919\">supraventricular</span> and <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> arrhythmias.</li>\n<li>Congestive heart failure: Decreases mortality.</li>\n<li>Thyrotoxicosis: Propranolol controls the <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> symptoms</li>\n<li>Glaucoma: Timolol and Betaxolol are used.</li>\n<li>Hypertrophic Cardiomyopathy (Improves <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output).</li>\n<li>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> (Ml): Secondary <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of Ml and myocardial <span class=\"customMeta\" data-dictid=\"53d0f40d261692777198244a05ec72\">salvage</span> during evolution of Ml (decreases mortality).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Beta-blockers should be avoided in all except.", "options": [{"label": "A", "text": "Asthma", "correct": false}, {"label": "B", "text": "Glaucoma", "correct": true}, {"label": "C", "text": "Bradycardia", "correct": false}, {"label": "D", "text": "Hypothyroidism", "correct": false}], "correct_answer": "B. Glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Glaucoma&lt;br/&gt;\n&lt;br/&gt;\nExplanation:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Types of beta-blocker </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-selective beta-blocker </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Propranolol, nadolol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Angina</li>\n<li>Arrhythmias</li>\n<li>Migraine prophylaxis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Beta-1-selective blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Metoprolol, Atenolol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Heart failure</li>\n<li>Arrhythmias</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Beta-1-with Alpha-1 blockade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Carvedilol, Labetalol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Heart failure</li>\n<li>Post-MI</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects of beta-blocker </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cardiac</strong> side effects</p>\n<ul>\n<li>Precipitation of an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> MI.</li>\n<li>Sinus <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> and heart block. <strong> (Option C)</strong></li>\n<li>Heart failure may exacerbate symptoms in patients with <span class=\"customMeta\" data-dictid=\"da8747dcd51692777185e1ed0554cc\">decompensated</span> <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> or preexisting myocardial dysfunction.</li>\n</ul>\n<p><strong>Extracardiac</strong> side effects</p>\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> resistance; hence, it is contraindicated in patients with <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> due to bronchospasm.<strong> </strong><strong>(Option A)</strong></li>\n<li>Exacerbation of <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> disease and worsen <span class=\"customMeta\" data-dictid=\"f01241cd50169277718482b7ac00eb\">claudication</span> and <span class=\"customMeta\" data-dictid=\"eba5ba77ec169277719688fab52fb0\">precipitate</span> Raynaud's disease.</li>\n<li>In Hypoglycemia, Beta-blockers mask the signs seen in a <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> patient, such as tachycardia.</li>\n<li>Hyperkalemia</li>\n<li>Depression, fatigue, and sexual <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> such as <span class=\"customMeta\" data-dictid=\"5cc2a2112e16927771874c5d97065a\">erectile</span> dysfunction.</li>\n<li>Weight gain</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old male presents with complaints of a weak urinary stream and frequent urination in small amounts and is on prazosin. He also mentions that he frequently feels light-headed and has low blood pressure. Which of the following alpha-blockers would you prefer to give him?", "options": [{"label": "A", "text": "Alfuzosin", "correct": false}, {"label": "B", "text": "Terazosin", "correct": false}, {"label": "C", "text": "Tamsulosin", "correct": true}, {"label": "D", "text": "Doxazosin", "correct": false}], "correct_answer": "C. Tamsulosin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Tamsulosin&lt;br/&gt;\nExplanation:</p>\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Types</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Alpha blockers </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-competitive + <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> type</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Phenoxybenzamine</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Competitive + <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> type</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Non-<br/>\n\t\t\tselective</strong></p>\n</td>\n<td colspan=\"3\" rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Phentolamine</li>\n<li>Ergotamine</li>\n<li>Ergotoxine</li>\n<li>Chlorpromazine</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Alpha 1 selective</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 1 a</strong></p>\n<ul>\n<li>Tamsulosin</li>\n<li>Silodosin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Internal urethral <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> and Iris</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ejaculation failure/retrograde ejaculation, miosis, increased <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 1 b</strong></p>\n<ul>\n<li>Alfuzosin</li>\n<li>Doxazosin</li>\n<li>Prazosin</li>\n<li>Terazosin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vascular Smooth muscle</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vasodilatation, <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tachycardia, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> GFR (thus leading to RAAS activation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 2 selective</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Yohimbine</li>\n<li>Idoxazon</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Central nervous system</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Penile <span class=\"customMeta\" data-dictid=\"322d94cd5816927771872f3d8d132b\">erection</span> (used in depression with sexual dysfunction)</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to the emergency department with diarrhea, sweating, excessive lacrimation, and salivation . His pulse rate is 55/min and his plasma cholinesterase level was 50U/mL . Which of the following can be used to treat this patient?", "options": [{"label": "A", "text": "Neostigmine", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Epinephrine", "correct": false}, {"label": "D", "text": "Benztropine", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is the following drug that causes postural hypotension commonly ?", "options": [{"label": "A", "text": "Beta blocker", "correct": false}, {"label": "B", "text": "Alpha blocker", "correct": true}, {"label": "C", "text": "ACE inhibitor", "correct": false}, {"label": "D", "text": "Angiotensin receptor blockers", "correct": false}], "correct_answer": "B. Alpha blocker", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\"&gt;Alpha&lt;/span&gt; block\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Apart from mu-opioid receptors , on which other receptor does tramadol act?", "options": [{"label": "A", "text": "Anticholinergic", "correct": false}, {"label": "B", "text": "5HT 1a inhibition", "correct": false}, {"label": "C", "text": "Serotonergic and norepinephrine reuptake inhibition", "correct": true}, {"label": "D", "text": "Antihistaminic", "correct": false}], "correct_answer": "C. Serotonergic and norepinephrine reuptake inhibition", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"ff0f0a7e341692777198133f3861c7\"&gt;Serotonergic&lt;/span&gt; and &lt;span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\"&gt;norepinephrine&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\"&gt;reuptake&lt;/span&gt; inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the options below acts as a selective alpha-1 receptor antagonist in medical practice?", "options": [{"label": "A", "text": "Phenoxybenzamine", "correct": false}, {"label": "B", "text": "Phentolamine", "correct": false}, {"label": "C", "text": "Prazosin", "correct": true}, {"label": "D", "text": "Idazoxan", "correct": false}], "correct_answer": "C. Prazosin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Chelator contraindicated in Iron poisoning?", "options": [{"label": "A", "text": "Calcium disodium EDTA", "correct": false}, {"label": "B", "text": "Deferoxamine", "correct": false}, {"label": "C", "text": "British anti lewsite (BAL)", "correct": true}, {"label": "D", "text": "Penicillamine", "correct": false}], "correct_answer": "C. British anti lewsite (BAL)", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - British Anti-Lewisite (BAL)\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Example of SNRI antidepressant drug", "options": [{"label": "A", "text": "Reboxatine", "correct": true}, {"label": "B", "text": "Tramadol", "correct": false}, {"label": "C", "text": "Paroxetine", "correct": false}, {"label": "D", "text": "Bupropion", "correct": false}], "correct_answer": "A. Reboxatine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - R\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 10-year-old child is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and is started on medication to increase norepinephrine levels as part of the treatment plan. Which of the following drugs is used for this purpose, and what is its mechanism of action?", "options": [{"label": "A", "text": "Methylphenidate", "correct": true}, {"label": "B", "text": "Reboxetine", "correct": false}, {"label": "C", "text": "Amitriptyline", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Methylphenidate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Methylph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old patient has just undergone surgery and required a drug to reverse the muscle relaxation induced during the procedure. Which of the following drugs is used for this purpose?", "options": [{"label": "A", "text": "Bethanechol", "correct": false}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Neostigmine", "correct": true}, {"label": "D", "text": "Edrophonium", "correct": false}], "correct_answer": "C. Neostigmine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female patient with a history of bronchial asthma has developed an acute attack of migraine. Which drug should be avoided?", "options": [{"label": "A", "text": "Sumatriptan", "correct": false}, {"label": "B", "text": "Propranolol", "correct": true}, {"label": "C", "text": "Ergotamine", "correct": false}, {"label": "D", "text": "Lasmiditan", "correct": false}], "correct_answer": "B. Propranolol", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is used to test for Myasthenia Gravis?", "options": [{"label": "A", "text": "Pyridostigmine", "correct": false}, {"label": "B", "text": "Neostigmine", "correct": false}, {"label": "C", "text": "Edrophonium", "correct": true}, {"label": "D", "text": "Atropine", "correct": false}], "correct_answer": "C. Edrophonium", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/PQaoPTtXdaKBrK5qYTe31747377620.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: a. Beta 1. Indacaterol b. Beta 1 2. Mirabegron c. Beta 2 3. Isoproterenol d. Beta 3 4. Betaxolol", "options": [{"label": "A", "text": "a-2, b-3, c-1, d-4", "correct": false}, {"label": "B", "text": "a-3, b-2, c-4, d-1", "correct": false}, {"label": "C", "text": "a-3, b-4, c-1, d-2", "correct": true}, {"label": "D", "text": "a-4, b-3, c-2, d-1", "correct": false}], "correct_answer": "C. a-3, b-4, c-1, d-2", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - a-3, b-4, c-1, d-2</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Receptors </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Beta</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Isoproterenol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Beta 1</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Betaxolol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Beta 2</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Indacaterol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Beta 3</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Mirabegron</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A chronic smoker was taking nicotine therapy and clonidine tablets for smoking de-addiction. He stopped taking clonidine tablets and developed a headache. What is the reason behind this?", "options": [{"label": "A", "text": "Postural hypotension", "correct": false}, {"label": "B", "text": "Receptor downregulation", "correct": false}, {"label": "C", "text": "Rebound hypertension", "correct": true}, {"label": "D", "text": "Receptor hypersensitivity", "correct": false}], "correct_answer": "C. Rebound hypertension", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"a4812dcf9b169277719756aaf48b7c\"&gt;Rebound&lt;/span&gt; h\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rebound Hypertension</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A sudden increase in blood pressure, headache, palpitations, sweating, anxiety, dizziness, confusion, chest pain.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Based on symptoms and <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> readings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Gradual tapering of the medication, <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> monitoring, and use of alternative medications if needed.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Prevention </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Avoid abrupt discontinuation of medications and gradual tapering under medical supervision.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient comes to the casualty with consumption of OPC pesticide. He was started on IV atropine infusion and pralidoxime. After 2 hours, the patient had a sudden rise in temperature. What is the cause of the fever?", "options": [{"label": "A", "text": "Atropine toxicity", "correct": true}, {"label": "B", "text": "A side effect of pralidoxime", "correct": false}, {"label": "C", "text": "Due to organophosphate poisoning", "correct": false}, {"label": "D", "text": "Idiopathic", "correct": false}], "correct_answer": "A. Atropine toxicity", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\"&gt;Atropine&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young male patient presents with ptosis and muscle weakness, which reportedly worsens in the evening and improves in the morning. This is relieved by neostigmine. What is the likely diagnosis?", "options": [{"label": "A", "text": "Myasthenia gravis", "correct": true}, {"label": "B", "text": "Huntington chorea", "correct": false}, {"label": "C", "text": "Amyotrophic lateral sclerosis", "correct": false}, {"label": "D", "text": "External ophthalmoplegia", "correct": false}], "correct_answer": "A. Myasthenia gravis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"6fa809ad22169277719323eaa30f1e\"&gt;Myasthenia&lt;/span&gt; gravis:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Pathophysiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Autoimmune disease is caused by antibodies <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> receptors at the <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> junction.</p>\n<p>Disruption in <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> transmission occurs through:</p>\n<ul>\n<li>Blockage of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> receptors.</li>\n<li>Complement-mediated <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> leads to:\n\t\t\t\t<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> count.</li>\n<li>Damage to the end plate.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Fatigable muscle weakness: <span class=\"customMeta\" data-dictid=\"cba1b0e9ae1692777193338c1ab85f\">Muscle strength</span> decreases with continued use, especially:\n\t\t\t\t<ul>\n<li>Later in the day</li>\n<li>After exercise</li>\n</ul>\n</li>\n<li>No <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> or <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> involvement, distinguishing it from other neurological disorders.</li>\n</ul>\n<p><strong>Common Initial Symptoms:</strong></p>\n<ul>\n<li>Ptosis (drooping eyelid)</li>\n<li>Diplopia (double vision)</li>\n<li>Weakness can spread to:\n\t\t\t\t<ul>\n<li>Chewing, swallowing, and speaking muscles</li>\n<li>Limb muscles</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tensilon (edrophonium) Test</strong></p>\n<ul>\n<li>This involves the <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> of Edrophonium (a short-acting <span class=\"customMeta\" data-dictid=\"16b654488116927771813c39bf19e7\">anticholinesterase</span> agent) into individuals with a <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> receptors at the <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> junction.</li>\n<li><strong>Steps: </strong>2 mg i.v. Edrophonium → Observe for any adverse reactions → If no adverse reactions occur after 30–60 seconds, the remaining 8 mg is injected.</li>\n</ul>\n<ul>\n<li>If <span class=\"customMeta\" data-dictid=\"cba1b0e9ae1692777193338c1ab85f\">muscle strength</span> improves after the administration of edrophonium, it indicates the presence of <span class=\"customMeta\" data-dictid=\"6fa809ad22169277719323eaa30f1e\">Myasthenia</span> Gravis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anticholinesterase agents (inhibit the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of <span class=\"customMeta\" data-dictid=\"fba05f424716927771802b63f6c392\">ACh</span> by <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> and increase <span class=\"customMeta\" data-dictid=\"e91c7a22e71692777196ef9e02b8c0\">presynaptic</span> levels of ACh, allowing for muscle contraction).</p>\n<ul>\n<li>Pyridostigmine (drug of choice)</li>\n<li>Neostigmine</li>\n<li>Ambenonium</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Unknown fruit consumption by a child, odd behaviour, fever and low urine output. Causative fruit and treatment is:", "options": [{"label": "A", "text": "Datura - PAM", "correct": false}, {"label": "B", "text": "Datura - Physostigmine", "correct": true}, {"label": "C", "text": "Yellow oleander - Digibind", "correct": false}, {"label": "D", "text": "Yellow oleander - Physostigmine", "correct": false}], "correct_answer": "B. Datura - Physostigmine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/In4w4teMAWqJ8aoUCHuA1745308895.png"], "explanation": "<p>Correct Answer B) Datura - Physostig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What treatment can be administered to a patient brought to the emergency department with symptoms of diarrhea, sweating, excessive lacrimation, salivation, a garlicky odor, a pulse rate of 55/min, and a plasma cholinesterase level of 50 U/mL?", "options": [{"label": "A", "text": "Neostigmine", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Epinephrine", "correct": false}, {"label": "D", "text": "Benztropine", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Atropine</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<thead>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Organophosphate poisoning</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Common exposures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pesticide: Farmer/field worker, <span class=\"customMeta\" data-dictid=\"318e52e4751692777195acbcdf4551\">pediatric</span> ingestion, suicide attempt</li>\n<li>Nerve agent: Multiple patients presenting with similar symptoms</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Manifestations</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Muscarinic <strong>(DUMBBELSS) :</strong></p>\n<ul>\n<li><strong>D-</strong>Diarrhea</li>\n<li><strong>U-</strong>Urination</li>\n<li><strong>M-</strong>Miosis</li>\n<li><strong>B-</strong>Bronchospasms, bronchorrhea, bradycardia</li>\n<li><strong>E-</strong>Excitation, Emesis</li>\n<li><strong>L-</strong>Lacrimation</li>\n<li><strong>S-</strong>Salivation, sweating</li>\n</ul>\n<p>Nicotinic:</p>\n<ul>\n<li>Muscle weakness, paralysis, fasciculations.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Decontamination</li>\n<li>Atropine reverses <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> symptoms</li>\n<li>Pralidoxime reverses <span class=\"customMeta\" data-dictid=\"c10496dcc416927771937d7280d782\">nicotinic</span> and <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> symptoms (reactivates cholinesterase)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A man was brought to the emergency room after poisoning with an unknown substance. Muscarinic poisoning was suspected, and he was treated for the same. What is the possible presenting feature that led to the diagnosis?", "options": [{"label": "A", "text": "Mydriasis", "correct": false}, {"label": "B", "text": "Diuresis", "correct": false}, {"label": "C", "text": "Muscle fasciculations", "correct": false}, {"label": "D", "text": "Bradycardia", "correct": true}], "correct_answer": "D. Bradycardia", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Muscarinic poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Laboratory Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>RBC/True Cholinesterase</strong> (specific)</li>\n<li><strong>Plasma/Pseudocholinesterase</strong> (Most common)\n\t\t\t\t<ul>\n<li>Falls rapidly with <span class=\"customMeta\" data-dictid=\"8e1f460230169277719463930573a7\">organophosphorus</span> poisoning</li>\n<li>Inexpensive, sensitive)</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Atropine test</strong>: If 2 mg of <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">Atropine</span> relieves symptoms, it confirms OP poisoning</li>\n<li><strong>P-nitro <span class=\"customMeta\" data-dictid=\"0d5565e4a1169277719596227ebffd\">phenol</span> test</strong> for confirmation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Resuscitative measures (Airway-Breathing-Circulation)</li>\n<li>Decontamination</li>\n<li>Gastric <span class=\"customMeta\" data-dictid=\"b625b3e881169277719169ef4e1af3\">lavage</span> with 1:5000 KMnO4</li>\n<li>Activated charcoal</li>\n<li><strong>Atropine sulfate</strong> (2-4 mg IV every 10-15 minutes until atropinization)</li>\n<li><strong>Signs of atropinization:</strong> Heart rate&gt;80 beats/min, pupils no longer pinpoint, clear chest on <span class=\"customMeta\" data-dictid=\"b2f0dbabe516927771821b0ec5ba85\">auscultation</span> with no wheeze, <span class=\"customMeta\" data-dictid=\"cf69f5256416927771991c21f264ae\">systolic</span> BP&gt;80mmHg, Dry axillae</li>\n<li>Oximes (Pralidoxime) to decrease <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> and <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> symptoms\n\t\t\t\t<ul>\n<li>removes <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> group</li>\n<li>reduces <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">atropine</span> requirement</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cause of Death</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Respiratory Muscle <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">Paralysis</span> (RMP)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with erectile dysfunction is given sildenafil. The penile erectile function is found to be improved after the therapy. Which of the following mediates the action of sildenafil ?", "options": [{"label": "A", "text": "cAMP", "correct": false}, {"label": "B", "text": "cGMP", "correct": true}, {"label": "C", "text": "Calcium", "correct": false}, {"label": "D", "text": "Phosphatidyl glycerol and inositol phosphate", "correct": false}], "correct_answer": "B. cGMP", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:542px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sildenafil</p>\n<p>↓</p>\n<p>Inhibits phosphodiesterase-5 (PDE-5) enzyme</p>\n<p>↓</p>\n<p>Prevents <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> degradation</p>\n<p>↓</p>\n<p>Increases cytosolic <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> levels</p>\n<p>↓</p>\n<p>Prolongs <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of GMP-dependent protein kinase</p>\n<p>↓</p>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"99c8e09d6f1692777193d7716ab6eb\">myosin</span> <span class=\"customMeta\" data-dictid=\"578fe8d7dd16927771913c847ed254\">light chain</span> <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> dephosphorylation</p>\n<p>↓</p>\n<p>Smooth muscle <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> in the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> cavernosum</p>\n<p>↓</p>\n<p>Increased blood flow</p>\n<p>↓</p>\n<p>Sustained penile erection</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is a β2 agonist? Dopexamine Dipivefrine Fenoldopam Mirabegron", "options": [{"label": "A", "text": "1,2,3", "correct": false}, {"label": "B", "text": "4,3,2,1", "correct": false}, {"label": "C", "text": "1,2", "correct": true}, {"label": "D", "text": "3,4", "correct": false}], "correct_answer": "C. 1,2", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism by which acetylcholine causes a decrease in the heart rate ?", "options": [{"label": "A", "text": "Delayed diastolic depolarization", "correct": true}, {"label": "B", "text": "Increase in plateau", "correct": false}, {"label": "C", "text": "Decrease in preload", "correct": false}, {"label": "D", "text": "Increase in afterload", "correct": false}], "correct_answer": "A. Delayed diastolic depolarization", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following cannot be used to decrease intraocular pressure in glaucoma ?", "options": [{"label": "A", "text": "Dexamethasone", "correct": true}, {"label": "B", "text": "Acetazolamide", "correct": false}, {"label": "C", "text": "Apraclonidine", "correct": false}, {"label": "D", "text": "Mannitol", "correct": false}], "correct_answer": "A. Dexamethasone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Dexameth\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Medication</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Prostaglandin analogs</p>\n</td>\n<td>\n<p>Increase uveoscleral outflow of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Beta blockers</p>\n</td>\n<td>\n<p>Decrease production of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alpha-adrenergic agonists</p>\n</td>\n<td>\n<p>Decrease production and increase outflow of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors</p>\n</td>\n<td>\n<p>Decrease production of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Miotic agents</p>\n</td>\n<td>\n<p>Increase outflow of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Osmotic agents</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure by osmotic effect</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Pilocarpine produces:", "options": [{"label": "A", "text": "Active miosis", "correct": true}, {"label": "B", "text": "Active mydriasis", "correct": false}, {"label": "C", "text": "Passive miosis", "correct": false}, {"label": "D", "text": "Passive mydriasis", "correct": false}], "correct_answer": "A. Active miosis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Activ\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-year-old male child is brought to the ophthalmology clinic by his mother with complaints of blurring of vision for one week. The patient further explains that he only has blurring of the far vision and has no problem in his near vision. The patient gives a history of no other abnormalities. For a detailed examination of the eye, the doctor uses a short-acting topical medication which also has a cycloplegic effect. Which of the following drug was used by the doctor in this case?", "options": [{"label": "A", "text": "Atropine oral", "correct": false}, {"label": "B", "text": "Atropine eye ointment", "correct": false}, {"label": "C", "text": "Tropicamide eye drops", "correct": true}, {"label": "D", "text": "Phenylephrine eye drops", "correct": false}], "correct_answer": "C. Tropicamide eye drops", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - T\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Cycloplegic Drug</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Duration of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Tropicamide</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Short-acting (3-6 hours)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Cyclopentolate</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Intermediate-acting (6-24 hours)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Homatropine</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Intermediate-acting (6-24 hours)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Atropine</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Long-acting (up to 7 days)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Scopolamine</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Long-acting (up to 7 days)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Intravenous mannitol is used in ____________?", "options": [{"label": "A", "text": "Pulmonary edema", "correct": false}, {"label": "B", "text": "Congestive cardiac failure", "correct": false}, {"label": "C", "text": "Acute kidney injury with anuria", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": true}], "correct_answer": "D. Glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Glau\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the drug used to differentiate myasthenia gravis from cholinergic crisis ?", "options": [{"label": "A", "text": "Obidoxime", "correct": false}, {"label": "B", "text": "Edrophonium", "correct": true}, {"label": "C", "text": "Donepezil", "correct": false}, {"label": "D", "text": "Atropine", "correct": false}], "correct_answer": "B. Edrophonium", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Edrophoniu\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Myasthenia Gravis (MG)</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Cholinergic Crisis</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Edrophonium Test</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Definition</strong></p>\n</td>\n<td>\n<p>Autoimmune disorder affecting <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> junction</p>\n</td>\n<td>\n<p>Excessive <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> of <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> receptors</p>\n</td>\n<td>\n<p><strong>Diagnostic test t</strong>o <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> MG from <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> crisis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Symptoms</strong></p>\n</td>\n<td>\n<p>Muscle weakness, fatigue</p>\n</td>\n<td>\n<p>Profound muscle weakness, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> distress</p>\n</td>\n<td>\n<p>Temporary improvement of <span class=\"customMeta\" data-dictid=\"cba1b0e9ae1692777193338c1ab85f\">muscle strength</span> in MG, worsening of symptoms in <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> crisis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Cause</strong></p>\n</td>\n<td>\n<p>Antibodies attacking <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> receptors</p>\n</td>\n<td>\n<p>Excessive <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> due to overstimulation</p>\n</td>\n<td>\n<ul>\n<li><strong>In MG:</strong> Temporary increase in <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> concentration at <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> junction</li>\n<li><strong>In <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">Cholinergic</span> Crisis</strong>: Worsening of symptoms due to increased <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> levels</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Response to Edrophonium</strong></p>\n</td>\n<td>\n<p>Temporary improvement in muscle strength</p>\n</td>\n<td>\n<p>Worsening of symptoms</p>\n</td>\n<td>\n<p>Positive response in MG, Negative/worsening response in <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">cholinergic</span> crisis</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\">\n<p><strong>Mechanism</strong></p>\n<p> </p>\n</td>\n<td colspan=\"1\" rowspan=\"2\">\n<p>Acetylcholinesterase inhibitor</p>\n<p> </p>\n</td>\n<td colspan=\"1\" rowspan=\"2\">\n<p>Acetylcholine <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> overstimulation</p>\n<p> </p>\n</td>\n<td colspan=\"1\" rowspan=\"2\">\n<ul>\n<li><strong>In MG</strong>: Inhibits acetylcholinesterase, increasing <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> availability</li>\n<li><strong>In <span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\">Cholinergic</span> Crisis</strong>: Further increases <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> levels, worsening symptoms</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antiglaucoma medications is unsafe in infants ?", "options": [{"label": "A", "text": "Timolol", "correct": false}, {"label": "B", "text": "Brimonidine", "correct": true}, {"label": "C", "text": "Latanoprost", "correct": false}, {"label": "D", "text": "Dorzolamide", "correct": false}], "correct_answer": "B. Brimonidine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - B\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Immediate treatment of anaphylaxic shock is:", "options": [{"label": "A", "text": "Hydrocortisone", "correct": false}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Adrenaline", "correct": true}, {"label": "D", "text": "Benzylpenicillin", "correct": false}], "correct_answer": "C. Adrenaline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Mechanism of action of atropine in treatment of organophosphate poisoning is ?", "options": [{"label": "A", "text": "It inhibits secretion of acetylcholine", "correct": false}, {"label": "B", "text": "It is reactivation of acetylcholinesterase enzyme", "correct": false}, {"label": "C", "text": "It has antimuscarinic activity", "correct": true}, {"label": "D", "text": "It is agonist of acetylcholine receptors", "correct": false}], "correct_answer": "C. It has antimuscarinic activity", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - It has &lt;span class=\"customMeta\" data-dictid=\"0c922f341d1692777181ff01d9031a\"&gt;antimuscarinic&lt;/span&gt; activ\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred medication for managing Alzheimer's disease?", "options": [{"label": "A", "text": "Donepezil", "correct": true}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Physostigmine", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Donepezil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a long acting bronchodilator ?", "options": [{"label": "A", "text": "Salbutamol", "correct": false}, {"label": "B", "text": "Terbutaline", "correct": false}, {"label": "C", "text": "Adrenaline", "correct": false}, {"label": "D", "text": "Formoterol", "correct": true}], "correct_answer": "D. Formoterol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - F\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is most likely to cause tremors with prolonged use?", "options": [{"label": "A", "text": "Salbutamol", "correct": true}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Betaxolol", "correct": false}, {"label": "D", "text": "Timolol", "correct": false}], "correct_answer": "A. Salbutamol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Salbutamol: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the possible cause of poisoning in a farmer who has a pin-point pupil and an increase in secretions?", "options": [{"label": "A", "text": "Organophosphate poisoning", "correct": true}, {"label": "B", "text": "Dhatura poisoning", "correct": false}, {"label": "C", "text": "Opioid poisoning", "correct": false}, {"label": "D", "text": "Atropine poisoning", "correct": false}], "correct_answer": "A. Organophosphate poisoning", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"505a21f8451692777194a113951c68\"&gt;Organophosphate&lt;/span&gt; poisoning\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What dose of epinephrine is used anaphylactic shock ?", "options": [{"label": "A", "text": "1:10000 I.V. - 10 ml", "correct": false}, {"label": "B", "text": "1:1000 I.M. - 0.5 ml", "correct": true}, {"label": "C", "text": "1:1000 I.M. - 1 ml", "correct": false}, {"label": "D", "text": "1:1000 I.V.- 0.5 ml", "correct": false}], "correct_answer": "B. 1:1000 I.M. - 0.5 ml", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - 1:1000 I.M. - 0.5\n<table border=\"1\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align: center;\"><strong>Adrenaline Concentration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align: center;\"><strong>Common Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>1:1,000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Treatment of severe allergic reactions, such as anaphylaxis</p>\n</li>\n<li>\n<p>Cardiac arrest resuscitation</p>\n</li>\n<li>\n<p>Management of <span class=\"customMeta\" data-dictid=\"9bde62b1091692777183cd433d9d47\">bronchospasm</span> in <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> and other <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> conditions</p>\n</li>\n<li>\n<p>Hemostasis in minor <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> procedures</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>1:10,000 (0.1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Cardiac arrest resuscitation</p>\n</li>\n<li>\n<p>Severe <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> or heart block</p>\n</li>\n<li>\n<p>Management of life-threatening arrhythmias</p>\n</li>\n<li>\n<p>Hypotension during <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> or shock</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Intranasal formulations</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> congestion</p>\n</li>\n<li>\n<p>Epistaxis (nosebleeds) control</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Inhalation formulations</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Management of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> attacks</p>\n</li>\n<li>\n<p>Reversal of <span class=\"customMeta\" data-dictid=\"9bde62b1091692777183cd433d9d47\">bronchospasm</span> due to <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> conditions</p>\n</li>\n<li>\n<p>Respiratory support in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"afafb9026e1692777186e3dd168fa8\">distress</span> or failure</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Topical formulations</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Hemostasis in minor cuts, wounds, or mucosal bleeding</p>\n</li>\n<li>\n<p>Local <span class=\"customMeta\" data-dictid=\"3f0b42b17016927772014c586d44b7\">vasoconstriction</span> during procedures (e.g., to control bleeding)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Eye drop formulations</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Mydriasis (pupil dilation) for <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> examinations</p>\n</li>\n<li>\n<p>Relief of <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> redness and <span class=\"customMeta\" data-dictid=\"8f179d376f16927771905338bc9387\">itching</span> due to allergies or inflammation</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient came to the causality with acute bronchial asthma after treatment for glaucoma . Which of the following is a most probable causative agent?", "options": [{"label": "A", "text": "Timolol", "correct": true}, {"label": "B", "text": "Betaxolol", "correct": false}, {"label": "C", "text": "Latanoprost", "correct": false}, {"label": "D", "text": "Bimatoprost", "correct": false}], "correct_answer": "A. Timolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - T\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Class of Drug</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Prostaglandin analogs</p>\n</td>\n<td>\n<p>Latanoprost, Bimatoprost, Travoprost, Tafluprost</p>\n</td>\n<td>\n<p>Conjunctival hyperemia, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surface disease, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> pigmentation, <span class=\"customMeta\" data-dictid=\"5b4dd03e7d16927771877ac3787035\">eyelash</span> growth, uveitis, <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Beta-blockers</p>\n</td>\n<td>\n<p>Timolol, Betaxolol, Levobunolol, Carteolol, Metipranolol</p>\n</td>\n<td>\n<p>Bronchospasm, bradycardia, hypotension, fatigue, depression, impotence</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alpha-2 agonists</p>\n</td>\n<td>\n<p>Brimonidine</p>\n</td>\n<td>\n<p>Ocular allergy, dry mouth, fatigue, headache, hypotension, bradycardia, dizziness</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors</p>\n</td>\n<td>\n<p>Dorzolamide, Brinzolamide</p>\n</td>\n<td>\n<p>Bitter taste, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> stinging, blurred vision, dry mouth, fatigue, depression, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> disturbances</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Rho <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> inhibitors</p>\n</td>\n<td>\n<p>Netarsudil</p>\n</td>\n<td>\n<p>Ocular hyperemia, conjunctival hemorrhage, <span class=\"customMeta\" data-dictid=\"5b4dd03e7d16927771877ac3787035\">eyelash</span> growth</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following is a short-acting beta blocker ?", "options": [{"label": "A", "text": "Nadolol", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Esmolol", "correct": true}, {"label": "D", "text": "Atenolol", "correct": false}], "correct_answer": "C. Esmolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - E\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Class of <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">Beta</span> Blockers</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Selectivity</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Lipid Solubility</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Duration</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">First Generation</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Propranolol, Timolol</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Non-Selective</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Lipid Soluble</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Short to Intermediate</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Second Generation</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Metoprolol, Atenolol, Bisoprolol</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Beta-1 Selective</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Hydrophilic</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Intermediate</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Third Generation</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Carvedilol, Nebivolol</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Alpha-1/Beta Blocker, Beta-1 Selective</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Lipid soluble, hydrophilic</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Intermediate to long</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about the treatment of a farmer presenting with symptoms of diarrhea, sweating, excessive tearing, and salivation in the emergency department is not accurate?", "options": [{"label": "A", "text": "Carbamates bind to acetylcholinesterase irreversibly.", "correct": false}, {"label": "B", "text": "Atropine is used as an antidote for OP poisoning", "correct": false}, {"label": "C", "text": "Pralidoxime has a role in reversing the enzyme in carbamate poisoning", "correct": true}, {"label": "D", "text": "Succinylcholine use is avoided in rapid sequence intubation", "correct": false}], "correct_answer": "C. Pralidoxime has a role in reversing the enzyme in carbamate poisoning", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Pralidoxime has a role in reversing the &lt;span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\"&gt;enzyme&lt;/span&gt; in &lt;span class=\"customMeta\" data-dictid=\"1c84f47ead169277718314715645dd\"&gt;carbamate&lt;/span&gt; poisoning\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Indication</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Atropine</strong></p>\n</td>\n<td>\n<p>The competitive <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> at <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors</p>\n</td>\n<td>\n<p>Symptomatic relief of <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> symptoms (e.g., bradycardia, bronchoconstriction, sweating, salivation)</p>\n</td>\n<td>\n<p>Tachycardia, dry mouth, mydriasis, <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> retention</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Pralidoxime</strong></p>\n</td>\n<td>\n<p>Reactivates <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> by removing the OP molecule from the enzyme</p>\n</td>\n<td>\n<p>Reversal of <span class=\"customMeta\" data-dictid=\"8b19cd5e161692777193ad958e52e0\">neuromuscular</span> <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> and improvement of muscle strength; may improve <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> function and reduce the need for mechanical ventilation.</p>\n</td>\n<td>\n<p>Hypertension, tachycardia, blurred vision, headache</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Diazepam</strong></p>\n</td>\n<td>\n<p>Enhances the activity of GABA, an <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> <span class=\"customMeta\" data-dictid=\"e28fd027b416927771932bc23ba0a5\">neurotransmitter</span> in the brain</p>\n</td>\n<td>\n<p>Sedation, <span class=\"customMeta\" data-dictid=\"f350ca9b3516927771814951e4c70c\">anticonvulsant</span> activity, and relief of anxiety and agitation</p>\n</td>\n<td>\n<p>Drowsiness, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression, hypotension</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Midazolam</strong></p>\n</td>\n<td>\n<p>Enhances the activity of GABA, an <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> <span class=\"customMeta\" data-dictid=\"e28fd027b416927771932bc23ba0a5\">neurotransmitter</span> in the brain</p>\n</td>\n<td>\n<p>Sedation, <span class=\"customMeta\" data-dictid=\"f350ca9b3516927771814951e4c70c\">anticonvulsant</span> activity, and relief of anxiety and agitation</p>\n</td>\n<td>\n<p>Drowsiness, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression, hypotension</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 62 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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His blood pressure is 180/120mmHg. To manage his condition, a Phentolamine is administered. Later, he experiences an allergic reaction, and epinephrine is given to treat this condition. Which of the following best describes the Vasomotor reversal of Dale?", "options": [{"label": "A", "text": "Epinephrine administration after phentolamine causes an increased blood pressure.", "correct": false}, {"label": "B", "text": "Epinephrine administration after phentolamine causes decreased blood pressure.", "correct": true}, {"label": "C", "text": "Epinephrine administration after phentolamine causes an increased heart rate.", "correct": false}, {"label": "D", "text": "Epinephrine administration after phentolamine causes decrease in heart rate.", "correct": false}], "correct_answer": "B. Epinephrine administration after phentolamine causes decreased blood pressure.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QoDF2t6uwJBnERUW32zM1747212857.mp3", "video": ""}, {"text": "A 58-year-old patient presents with poorly controlled hypertension despite being on multiple antihypertensive medications. The physician initiates Clonidine therapy to help manage the patient's blood pressure. Which of the following is TRUE regarding the mechanism of action of Clonidine?", "options": [{"label": "A", "text": "Antagonises α2-adrenergic receptors.", "correct": false}, {"label": "B", "text": "Stimulates α1-adrenergic receptors.", "correct": false}, {"label": "C", "text": "Inhibits RAAS.", "correct": false}, {"label": "D", "text": "Stimulates α2-adrenergic receptors.", "correct": true}], "correct_answer": "D. Stimulates α2-adrenergic receptors.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/9D7GyFGwKxi0eJlYns5d1734421284.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"994\" src=\"https://image.prepladder.com/content/9D7GyFGwKxi0eJlYns5d1734421284.png\" width=\"654\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Diabetic diarrhoea</li>\n<li>Addiction withdrawal</li>\n<li>Menopausal hot flashes</li>\n<li>Diagnosing hypertension</li>\n<li>Suspected pheochromocytoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atrial fibrillation</li>\n<li>ADHD</li>\n<li>Tourette syndrome</li>\n<li>Hyperhidrosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/71XePZqm5RyxX2YIEX3U1747213006.mp3", "video": ""}, {"text": "What is the preferred medication for managing a hypertensive crisis caused by the sudden withdrawal of Clonidine?", "options": [{"label": "A", "text": "Intravenous labetalol", "correct": false}, {"label": "B", "text": "Phentolamine", "correct": true}, {"label": "C", "text": "Nitroglycerin", "correct": false}, {"label": "D", "text": "Amlodipine", "correct": false}], "correct_answer": "B. Phentolamine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4Xs1IsialVD22gyoznVY1747213127.mp3", "video": ""}, {"text": "A 32-year-old pregnant woman with chronic hypertension presents to her obstetrician's office for a routine prenatal visit. She has been managed with methyldopa for hypertension control. Which adverse effect should the physician monitor for during her treatment?", "options": [{"label": "A", "text": "Hyperkalemia", "correct": false}, {"label": "B", "text": "Hypertensive crisis", "correct": false}, {"label": "C", "text": "Hyperglycemia", "correct": false}, {"label": "D", "text": "Hemolytic anemia", "correct": true}], "correct_answer": "D. Hemolytic anemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Centrally converted to <span class=\"customMeta\" data-dictid=\"bc09155adc169277719248f9543785\">methyl</span> norepinephrine, exerting alpha-2 <span class=\"customMeta\" data-dictid=\"5d95021636169277718061efafd18d\">agonistic</span> action in the CNS, reducing <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> outflow.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Management of hypertension, particularly in pregnant women or those with <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> insufficiency.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, Diarrhea, Headache, Dizziness, Sedation, Dry mouth, Rash. Rare complications include Coombs-positive <span class=\"customMeta\" data-dictid=\"d30ae941d516927771889351160b00\">hemolytic</span> anaemia, lupus-like syndrome, myocarditis, pancreatitis, hepatotoxicity, and immune thrombocytopenia.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/v2b4LAQvjaOhhdWNgIES1747213249.mp3", "video": ""}, {"text": "A 52-year-old male with severe episodic hypertension, headaches, palpitations, and elevated urinary metanephrines is diagnosed with pheochromocytoma. What is the drug of choice to manage hypertension and symptoms before surgery?", "options": [{"label": "A", "text": "Propranolol", "correct": false}, {"label": "B", "text": "Phenoxybenzamine", "correct": true}, {"label": "C", "text": "Metoprolol", "correct": false}, {"label": "D", "text": "Prazosin", "correct": false}], "correct_answer": "B. Phenoxybenzamine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nonselective, <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> alpha-adrenergic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Forms <span class=\"customMeta\" data-dictid=\"d7f598a3db1692777185bf93a6e6fa\">covalent</span> bonds, likely with <span class=\"customMeta\" data-dictid=\"dabfa103741692777185dac756c49b\">cysteine</span> residues, within alpha-adrenergic receptors, reducing <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> effects <span class=\"customMeta\" data-dictid=\"f3063c1d8b169277719018bf869980\">induced</span> by catecholamines. Results in decreased <span class=\"customMeta\" data-dictid=\"3f0b42b17016927772014c586d44b7\">vasoconstriction</span> and <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> resistance.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Postural hypotension, palpitations, <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> congestion, miosis, <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of ejaculation.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9XhsLgYnBPILD9mSc4xM1747213388.mp3", "video": ""}, {"text": "During the surgical excision of a pheochromocytoma, a continuous IV infusion of an alpha blocker was used to prevent the intraoperative rise of blood pressure due to catecholamine spillage into the bloodstream from the tumor. Match the alpha-blockers with their appropriate class. a. Phenoxybenzamine 1. Alpha 1 selective b. Prazosin 2. Alpha Non-selective and reversible c. Phentolamine 3. Alpha 2 selective d. Yohimbine 4. Alpha Non-selective and irreversible", "options": [{"label": "A", "text": "a-2, b-3, c-1, d-4", "correct": false}, {"label": "B", "text": "a-4, b-1, c-2, d-3", "correct": true}, {"label": "C", "text": "a-1, b-3, c-2, d-4", "correct": false}, {"label": "D", "text": "a-3, b-2, c-4, d-1", "correct": false}], "correct_answer": "B. a-4, b-1, c-2, d-3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TYPES</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DRUGS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-competitive + <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> type</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenoxybenzamine</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Competitive + <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> type</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Non-selective</strong></p>\n</td>\n<td colspan=\"3\" rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phentolamine</p>\n<p>Ergotamine</p>\n<p>Ergotoxine</p>\n<p>Chlorpromazine</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Alpha 1 selective</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>LOCATION</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>EFFECTS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha 1 a</strong></p>\n<p>Tamsulosin</p>\n<p>Silodosin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Internal Urethral Sphincter</p>\n<p>Iris</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ejaculation failure/retrograde ejaculation, miosis, increased <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha 1 b</strong></p>\n<p>Alfuzosin</p>\n<p>Doxazosin</p>\n<p>Prazosin</p>\n<p>Terazosin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vascular Smooth Muscle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vasodilatation, <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tachycardia, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"1c745475f51692777188c744487e6f\">GFR</span> (thus leading to <span class=\"customMeta\" data-dictid=\"15d91786931692777197c8932c8000\">RAAS</span> activation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha 2 selective</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yohimbine</p>\n<p>Idoxazon</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Central Nervous System</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Penile <span class=\"customMeta\" data-dictid=\"322d94cd5816927771872f3d8d132b\">erection</span> (used in depression with sexual dysfunction)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/l1VuOrOAJWpchj5JAoFt1747213538.mp3", "video": ""}, {"text": "A 58-year-old man with benign prostate hypertrophy was recently prescribed Prazosin. Which side effects should the patient be informed about before starting the medication? Postural hypotension Retrograde ejaculation Floppy iris syndrome Reflex bradycardia", "options": [{"label": "A", "text": "1 and 2", "correct": false}, {"label": "B", "text": "1 and 3", "correct": false}, {"label": "C", "text": "1, 2 and 4", "correct": false}, {"label": "D", "text": "1, 2 and 3", "correct": true}], "correct_answer": "D. 1, 2 and 3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective α1-adrenergic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blocker</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>α1A <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> → relaxes <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> neck/prostate smooth muscle</p>\n<p>α1B <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> → vasodilation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BPH</p>\n<p>Hypertension</p>\n<p>Raynaud’s disease</p>\n<p>Scorpion bite</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bladder/Prostate Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ Outlet resistance → better <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> flow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vascular Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ Peripheral resistance → ↓ BP</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Postural hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common; occurs with first dose</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reflex tachycardia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Compensatory response to hypotension</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retrograde ejaculation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> of internal urethral sphincter</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Floppy <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen during eye surgery; risk increases with chronic use</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prazosin is a highly selective ɑ1 blocker</strong>s</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Postural <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> <strong>(first dose effect)</strong> - due to <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1b <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> on <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscles</li>\n<li><strong>Retrograde ejaculation</strong>: Due to <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1a receptors <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> on internal urethral sphincter</li>\n<li><strong>Floppy <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> syndrome</strong>: Due to the <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> of the <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> on the iris</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> occurs due to vasodilation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Benign prostatic hyperplasia</li>\n<li>Raynaud’s disease</li>\n<li>Scorpion Bite.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kbnp69VqlqjygJ4SJTKD1747213772.mp3", "video": ""}, {"text": "A 40-year-old man with a recent history of myocardial infarction was started on Beta blocker as a secondary prophylaxis of MI. Which of the following beta blockers is most cardioselective?", "options": [{"label": "A", "text": "Metoprolol", "correct": true}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Labetalol", "correct": false}, {"label": "D", "text": "Tilisolol.", "correct": false}], "correct_answer": "A. Metoprolol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:662px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First generation(Older / <span class=\"customMeta\" data-dictid=\"9996ef505516927771937fe4ef1222\">non</span> selective)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second generation </strong></p>\n<p><strong>(Cardioselective)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Third generation </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Propranolol <strong> </strong><strong>(Option B)</strong></p>\n<p>Sotalol</p>\n<p>Pindolol (100% bioavailability)</p>\n<p>Timolol</p>\n<p>Nadolol (Maximum t1/2)</p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metoprolol (Option A)</strong></p>\n<p>Esmolol (Minimum t1/2)</p>\n<p>Atenolol</p>\n<p><strong>Bisoprolol</strong></p>\n<p>Acebutolol</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With alpha-blocking activity</strong></p>\n<p>Labetalol <strong>(Option C)</strong></p>\n<p>Celiprolol</p>\n<p>Nebivolol (NO-releasing property)</p>\n<p>Betaxolol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockade</strong></p>\n<p>Carvedilol (maximum <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein binding )</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> 2 agonism </strong></p>\n<p>Bopindolol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With K+ channel opening action</strong></p>\n<p>Tilisolol <strong>(Option D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9J3KdvzG4qI2sRYMxztw1747213885.mp3", "video": ""}, {"text": "A 38-year-old female patient who was on propranolol developed bradycardia and was admitted to the cardiac ICU. On discharge, her medication was changed from propranolol to another beta-blocker, which has intrinsic sympathomimetic activity and membrane-stabilizing properties.Which of the following drugs was most likely prescribed?", "options": [{"label": "A", "text": "Carvedilol", "correct": false}, {"label": "B", "text": "Metoprolol", "correct": false}, {"label": "C", "text": "Pindolol", "correct": true}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "C. Pindolol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non selective 𝛃1 + 𝛃2 <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardioselective 𝛃1 <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Without ISA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With ISA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With ɑ <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> activity</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Metoprolol <strong>(Option B)</strong></li>\n<li>Esmolol</li>\n<li>Atenolol</li>\n<li>Bisoprolol</li>\n<li>Acebutolol</li>\n<li>Betaxolol</li>\n<li>Nebivolol</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Propranolol</li>\n</ul>\n<p><strong>(Option D)</strong><strong> </strong></p>\n<ul>\n<li>Sotalol</li>\n<li>Timolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pindolol</li>\n<li>Celiprolol</li>\n<li>Oxprenolol</li>\n<li>Penbutolol</li>\n<li>Pindolol</li>\n<li>Bopindolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Labetalol</li>\n<li>Carvedilol <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NrvKgV0zpQVuKMLX64Qv1747214023.mp3", "video": ""}, {"text": "A 63-year-old male has complained of tremors in his hands for the past two years. Physical examination reveals bilateral symmetric tremors predominantly in his hands, which worsen with intentional movements and are relieved by rest. Which of the following is the drug of choice in essential tremors?", "options": [{"label": "A", "text": "Propranolol", "correct": true}, {"label": "B", "text": "Levodopa", "correct": false}, {"label": "C", "text": "Diazepam", "correct": false}, {"label": "D", "text": "Gabapentin", "correct": false}], "correct_answer": "A. Propranolol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug of choice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Migraine prophylaxis</li>\n<li>Essential tremors</li>\n<li>Aortic <span class=\"customMeta\" data-dictid=\"e42da316b916927771860f0ba81c19\">dissection</span> if they also have hypertension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"8\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other Uses</strong></p>\n</td>\n<td rowspan=\"8\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertension-second-line drugs</li>\n<li>Stable angina: Decrease the frequency of attacks and increase exercise tolerance.</li>\n</ul>\n<ul>\n<li>Cardiac arrhythmias: Used in both <span class=\"customMeta\" data-dictid=\"619efd9f7b169277719928c9441919\">supraventricular</span> and <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> arrhythmias.</li>\n<li>Congestive heart failure: Decreases mortality.</li>\n<li>Thyrotoxicosis: <span class=\"customMeta\" data-dictid=\"082f7143eb1692777196df69a3b6cb\">Propranolol</span> controls the <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> symptoms</li>\n<li>Glaucoma: <span class=\"customMeta\" data-dictid=\"44f66117c1169277720085f515550a\">Timolol</span> and Betaxolol are used.</li>\n<li>Hypertrophic <span class=\"customMeta\" data-dictid=\"6e6dd7aed216927771831ebdf9703c\">Cardiomyopathy</span> (Improve <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output).</li>\n<li>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> (Ml): Secondary <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of Ml and myocardial <span class=\"customMeta\" data-dictid=\"53d0f40d261692777198244a05ec72\">salvage</span> during evolution of Ml (decreases mortality).</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5mheM6etI7fWCywhVR6e1747214131.mp3", "video": ""}, {"text": "A 45-year-old female with a history of hypertension on metoprolol presents for a routine follow-up. She mentions experiencing fatigue and occasional dizziness. She also notes episodes of constipation. Which of the following is NOT an adverse effect of beta blockers?", "options": [{"label": "A", "text": "Hyperkalemia", "correct": false}, {"label": "B", "text": "Hyperglycemia", "correct": false}, {"label": "C", "text": "Bronchospasm", "correct": false}, {"label": "D", "text": "Retrograde ejaculation", "correct": true}], "correct_answer": "D. Retrograde ejaculation", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DMl77mUQq2hR6r9HphAr1747214313.mp3", "video": ""}, {"text": "Which of the following calcium channel blockers can cause heart blockage when combined with beta-blockers in patients with heart failure?", "options": [{"label": "A", "text": "Nimodipine", "correct": false}, {"label": "B", "text": "Nifedipine", "correct": false}, {"label": "C", "text": "Amlodipine", "correct": false}, {"label": "D", "text": "Diltiazem", "correct": true}], "correct_answer": "D. Diltiazem", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DHP <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> Channel Blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-DHP <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> Channel Blockers</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Examples</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amlodipine, Nifedipine, Felodipine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diltiazem, Verapamil</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily block L-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels in <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Block L-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels in the heart</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Angina, rate control in arrhythmias</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peripheral edema, flushing, headache</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bradycardia, heart block, dizziness</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HUOtxdV10wtHrZhmOHkS1747214430.mp3", "video": ""}, {"text": "Which of the following symptoms of hypoglycemia is NOT masked by propranolol?", "options": [{"label": "A", "text": "Tremors", "correct": false}, {"label": "B", "text": "Palpitations", "correct": false}, {"label": "C", "text": "Tachycardia", "correct": false}, {"label": "D", "text": "Sweating", "correct": true}], "correct_answer": "D. Sweating", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WX2sxpCUtaD920XIlbun1747214599.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 23 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is not classified as a vasopressor among the sympathomimetic drugs?", "options": [{"label": "A", "text": "Midodrine", "correct": false}, {"label": "B", "text": "Ephedrine", "correct": false}, {"label": "C", "text": "Phenylephrine", "correct": false}, {"label": "D", "text": "Dobutamine", "correct": true}], "correct_answer": "D. Dobutamine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vasopressors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Selective α1 agonist</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenylephrine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC:</p>\n<ul>\n<li>Hypotension in <span class=\"customMeta\" data-dictid=\"b95d9432b316927771811d2040b80c\">aortic dissection</span> surgeries</li>\n<li>To treat <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> as a <span class=\"customMeta\" data-dictid=\"a7a960ea3e1692777201d2255a63f1\">vasopressor</span> in <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> anesthesia</li>\n<li>Mydriasis without cycloplegia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Midodrine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC: Postural hypotension</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α+β receptors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ephedrine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypotension in pregnancy.</p>\n<p>Phenylephrine is the preferred agent for <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> in pregnancy.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rDrvytzKiID2NCzaDXWv1747152575.mp3", "video": ""}, {"text": "A 45-year-old female with a BMI of 33 kg/m², currently on olanzapine, seeks treatment for obesity. The physician discusses various pharmacological options. Which newer approved anti-obesity drug might be effective for this patient, considering her olanzapine therapy?", "options": [{"label": "A", "text": "Rimonabant", "correct": false}, {"label": "B", "text": "Sibutramine", "correct": false}, {"label": "C", "text": "Samidorphan", "correct": true}, {"label": "D", "text": "Fenfluramine", "correct": false}], "correct_answer": "C. Samidorphan", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:663px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DRUG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>STATUS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Liraglutide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GLP-1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> that enhances <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">satiety</span> and slows <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying, leading to weight loss</p>\n<p>also used to treat <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Approved</p>\n<p>(Newer anti-obesity drug)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Samidorphan <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> blocks the effects of <span class=\"customMeta\" data-dictid=\"db32c78ec1169277719403869f60ef\">olanzapine</span> on the receptors and hence reduce the weight gain associated with Olanzapine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Approved</p>\n<p>(Newer anti-obesity drug)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Setmelanotide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> (activator) of the MC4R</p>\n<ul>\n<li>Decreases <span class=\"customMeta\" data-dictid=\"d4a253810c1692777181f708ba3dc6\">appetite</span> and increases the feeling of fullness (satiety)</li>\n<li>Increases energy expenditure and metabolism</li>\n<li>Promotes weight loss</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>(Newer anti-obesity drug)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rimonabant</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CB1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist; withdrawn due to psychiatric side effects.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Banned</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sibutramine <strong>(Option B)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Norepinephrine and <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> inhibitor</li>\n<li>Increase <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> activity by increasing <span class=\"customMeta\" data-dictid=\"38c81721001692777181c671bce8b3\">amine</span> levels in the brain.</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Banned (due to cardiotoxicity)</p>\n<p>(Withdrawn due to <span class=\"customMeta\" data-dictid=\"efba33a3fd1692777189906f884236\">heart valve</span> damage)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fenfluramine <strong>(Option D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:464px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Newer Anti-obesity drugs</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Banned anti-obesity drugs</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Liraglutide</li>\n<li>Samidorphan</li>\n<li>Setmelanotide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fenfluramine</li>\n<li>Sibutramine</li>\n<li>Rimonabant</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xiqDNR7SA1V1W23jp3QW1747154121.mp3", "video": ""}, {"text": "Which anti-obesity drugs work primarily by inhibiting pancreatic lipase, thereby reducing fat absorption in the gastrointestinal tract?", "options": [{"label": "A", "text": "Orlistat", "correct": true}, {"label": "B", "text": "Phentermine", "correct": false}, {"label": "C", "text": "Liraglutide", "correct": false}, {"label": "D", "text": "Bupropion", "correct": false}], "correct_answer": "A. Orlistat", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibitors of Lipase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Orlistat <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagon-like peptide-1 (GLP-1) <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> (Suppress appetite)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Liraglutide <strong>(Option C)</strong>,</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sympathomimetic <span class=\"customMeta\" data-dictid=\"38c81721001692777181c671bce8b3\">amine</span> (Suppress appetite)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amphetamine, <span class=\"customMeta\" data-dictid=\"209dbbc4351692777195121888ef13\">Phentermine</span> <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stimulators of Lipase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mirabegron</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid antagonists (Early satiety)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Topiramate, Naltrexone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Norepinephrine-dopamine <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (NDRI)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bupropion <strong>(Option D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CSdSvmhQADb0PORT4rJl1747153973.mp3", "video": ""}, {"text": "A 55-year-old male patient with a history of depression is being treated with phenelzine, a monoamine oxidase inhibitor (MAOI). He presents to the emergency department with a sudden onset of severe headache, palpitations, hypertension (blood pressure of 200/110 mmHg), and sweating. He reports consuming a large amount of aged cheese at a party earlier that evening.Which is the drug of choice for treating this patient's condition?", "options": [{"label": "A", "text": "Phentolamine", "correct": true}, {"label": "B", "text": "Labetalol", "correct": false}, {"label": "C", "text": "Hydralazine", "correct": false}, {"label": "D", "text": "Captopril", "correct": false}], "correct_answer": "A. Phentolamine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CHEESE REACTION</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause and Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The \"cheese reaction\" occurs when patients on MAOIs, such as phenelzine, consume foods high in <span class=\"customMeta\" data-dictid=\"ffbb7381b01692777201ad490eb131\">tyramine</span> (e.g., aged cheese).</li>\n<li>Tyramine is normally metabolized by <span class=\"customMeta\" data-dictid=\"f214e1c23316927771928fe9222ddc\">monoamine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> in the gut. However, MAOIs <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> this enzyme, leading to high levels of tyramine.</li>\n</ul>\n<ul>\n<li>Tyramine then enters the <span class=\"customMeta\" data-dictid=\"337d16dac5169277718474b97f6e4a\">circulation</span> and displaces <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> from storage vesicles in <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> neurons, resulting in a sudden and excessive release of norepinephrine. This leads to severe hypertension, headache, palpitations, and other symptoms.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Phentolamine, a non-specific <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> alpha-adrenergic blocker,</strong> is used to treat <span class=\"customMeta\" data-dictid=\"dd2daa0c6216927771893c9cab82d9\">hypertensive</span> emergencies caused by the cheese reaction.</li>\n<li>It counteracts the excessive effects of <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> alpha-adrenergic receptors, thereby <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> blood pressure.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7SIboFTRSOSjffxi1QgQ1747153841.mp3", "video": ""}, {"text": "A 32-week pregnant female is suspected of having premature labour in the next few days. Which of the following drugs can be administered to prevent the same?", "options": [{"label": "A", "text": "Phenylephrine", "correct": false}, {"label": "B", "text": "Ritodrine", "correct": true}, {"label": "C", "text": "Isoprenaline", "correct": false}, {"label": "D", "text": "Methoxamine", "correct": false}], "correct_answer": "B. Ritodrine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4cHrDWCUeyhrxKujB1YD1747153606.mp3", "video": ""}, {"text": "A 7-year-old child is brought to the clinician due to difficulties in concentrating, impulsivity, and excessive fidgeting at home and in school. After a thorough assessment, the child is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Which of the following medications would not be appropriate for the management of this child's symptoms?", "options": [{"label": "A", "text": "Methylphenidate", "correct": false}, {"label": "B", "text": "Atomoxetine", "correct": false}, {"label": "C", "text": "Clonidine", "correct": false}, {"label": "D", "text": "Lorazepam", "correct": true}], "correct_answer": "D. Lorazepam", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment of ADHD</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment of Choice</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cognitive behavioral therapy (CBT)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medical Management (if CBT is not effective)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stimulants</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-stimulants</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increase <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> activity.</li>\n<li>Increase attention span and academic performance.</li>\n<li>Cause hyperkinesia/tics.</li>\n<li>Rapid onset and short duration.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Do not produce excessive movements/tics.</li>\n<li>Delayed onset.</li>\n<li>Less abuse potential.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Methylphenidate:</strong> <strong>(Option A)</strong>\n<ol>\n<li><strong>Drug of choice</strong></li>\n<li>Increase brain catecholamines.</li>\n</ol>\n</li>\n<li>Dexamphetamine</li>\n<li>Lisdexamfetamine</li>\n<li>Dextroamphetamine</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Clonidine, Guanfacine: <strong>(Option C)</strong>\n<ol>\n<li>Treatment in ADHD with tics</li>\n</ol>\n</li>\n<li>Atomoxetine-SNRI</li>\n</ol>\n<p>CNS STIMULANTS(methylphenidate)- not preferred in children less than 7 years of age instead atomoxetine is preferred here(antidepressant)<br/>\n<strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects:</strong> Insomnia, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, and weight loss.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects: </strong>Insomnia, <span class=\"customMeta\" data-dictid=\"e3afd7f63b1692777186b9a6e7824d\">dry mouth</span> and decreased appetite.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zaqTGBMaUlqs0j8TZPSP1747153496.mp3", "video": ""}, {"text": "A 19-year-old college student is brought to the emergency after ingesting amphetamine pills night before his final exam. On examination, he presents with agitation, hyperthermia, and severe hypertension. His pupils are dilated, and urine catheterisation reveals dark urine. Which of the following is next best step for this patient?", "options": [{"label": "A", "text": "Administer intravenous sodium bicarbonate", "correct": false}, {"label": "B", "text": "Administer flumazenil", "correct": false}, {"label": "C", "text": "Administer ammonium chloride", "correct": true}, {"label": "D", "text": "Administer naloxone", "correct": false}], "correct_answer": "C. Administer ammonium chloride", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/br4sal4ybhCuUgPSuUYk1747153291.mp3", "video": ""}, {"text": "A 25-year-old male presents to the clinic with complaints of excessive daytime sleepiness with sudden episodes of muscle weakness triggered by emotions. He reports that these symptoms have been significantly impacting his work performance. Which of the following is the drug of choice for treating this condition?", "options": [{"label": "A", "text": "Zolpidem", "correct": false}, {"label": "B", "text": "Modafinil", "correct": true}, {"label": "C", "text": "Lorazepam", "correct": false}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "B. Modafinil", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FUUcSwxqbc4pQp2nOkpJ1747153098.mp3", "video": ""}, {"text": "A 60-year-old female presents to the clinic with complaints of frequent urination and incontinence. She has been diagnosed with overactive bladder and has tried lifestyle modifications with limited success. Her physician decides to start medication for her symptoms; it will act on which of the following receptors?", "options": [{"label": "A", "text": "Beta-3-agonist- Mirabegron", "correct": true}, {"label": "B", "text": "Beta-2-agonist- Terbutaline", "correct": false}, {"label": "C", "text": "Alpha-1-agonist- Phenylephrine", "correct": false}, {"label": "D", "text": "Alpha-1-antagonist- Tamsulosin", "correct": false}], "correct_answer": "A. Beta-3-agonist- Mirabegron", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sibutramine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mirabegron/Vebegron</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Promote lipolysis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Relax <span class=\"customMeta\" data-dictid=\"80d318a6701692777186805934d86a\">detrusor</span> muscles (increase <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> oxide).</li>\n<li>Inhibits micturition</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-obesity drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Overactive bladder</li>\n<li>Urinary incontinence</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiotoxic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increase blood pressure</li>\n<li>UTI</li>\n<li>CYP2D6 inhibitor</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qov5BmiREOTIGq2cePSO1747152966.mp3", "video": ""}, {"text": "A 45-year-old male with a history of chronic sinusitis presents with complaints of persistent anosmia and nasal discharge. He used an over-the-counter nasal decongestant daily for the past three months. Which of the following statement is false regarding the treatment of the this condition? A) It results from abruptly stopping the use of oxymetazoline nasal spray. B) Long-term use of nasal decongestants is recommended to prevent this condition. C) It is caused by ischemic atrophy of the nasal mucosa and olfactory nerve injury. D) These drugs act on the alpha-adrenergic receptor, inducing vasodilation in the nose. E) Oxymetazoline can also be used to treat cases of adult rosacea.", "options": [{"label": "A", "text": "2 and 4", "correct": true}, {"label": "B", "text": "2, 3 and 5", "correct": false}, {"label": "C", "text": "2, 3, 4 and 5", "correct": false}, {"label": "D", "text": "2 and 3", "correct": false}], "correct_answer": "A. 2 and 4", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/zh0BWEolVEA1v0lbOnkQ1734772739.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:630px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nasal drops</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Oral medication</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Xylometazoline</li>\n<li>Naphazoline</li>\n<li>Phenylephrine</li>\n<li>Oxymetazoline (otrivin)\n\t\t\t\t<ul>\n<li>Also used to treat <strong>adult <span class=\"customMeta\" data-dictid=\"65c199df6316927771976629902acc\">rosacea</span> (Statement E)</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ephedrine</li>\n<li>Pseudoephedrine</li>\n<li>Phenylephrine</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kIO6Z1pmsl26vdcoy2ld1747216691.mp3", "video": ""}, {"text": "A 5-year-old child is brought to the ophthalmologist for a routine eye examination. Which of the following drugs is most appropriate for pupillary dilation to assess the retina in this child?", "options": [{"label": "A", "text": "Phenylephrine", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Cyclopentolate", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration and side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atropine 1%<br/>\n<strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drug of choice in children</li>\n<li>Blocks <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> M3 receptors (overactive in children)</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> muscle <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> (Passive mydriasis)</li>\n<li>Use: mydriasis, cycloplegia, keratitis, iridocyclitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long-acting ( &gt;1 week)</li>\n<li>Photosensitivity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenylephrine<br/>\n\t\t\t2.5-10%<br/>\n<strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drug of choice in adults</li>\n<li>Stimulate alpha-1 receptors</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> of <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> muscles (Active mydriasis)</li>\n<li>Not used as cycloplegic</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Last several hours</li>\n<li>Increases blood pressure</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclopentolate<br/>\n\t\t\t0.5-2%<br/>\n<strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Same as atropine</li>\n<li>Use: iritis, uveitis, cycloplegia</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lasts one day</li>\n<li>Transient behavioural abnormalities in children</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tropicamide<br/>\n\t\t\t0.5-1%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Commonly used for office exams</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Effect for several hours</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QgLeL1X2VR9A7jU6gaNW1747152686.mp3", "video": ""}, {"text": "Which of the following diseases can be treated with a drug that inhibits vesicular monoamine transporters (VMAT)?", "options": [{"label": "A", "text": "Huntington’s chorea", "correct": true}, {"label": "B", "text": "Mononeuritis multiplex", "correct": false}, {"label": "C", "text": "Parkinson’s disease", "correct": false}, {"label": "D", "text": "Lewy body dementia", "correct": false}], "correct_answer": "A. Huntington’s chorea", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Centrally, this process mainly involves the release of dopamine, which is <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> in movement disorders involving excessive <span class=\"customMeta\" data-dictid=\"6aec63ba2e1692777186e5809a7376\">dopaminergic</span> activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peripherally, this process occurs at the <span class=\"customMeta\" data-dictid=\"5c4592475a1692777199991c761d11\">synaptic</span> terminals, which are responsible for maintaining blood pressure; hence, these drugs were once used to manage hypertension.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibitors: <strong>Tetrabenazine, deutetrabenazine, valbenazine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibitor: <strong>Reserpine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>These drugs selectively <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> VMAT-1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This drug inhibits both VMAT-1 &amp; VMAT-2</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QwaegNpANt8ozC110b3G1747150873.mp3", "video": ""}, {"text": "Which of the following statements about Dobutamine is correct?", "options": [{"label": "A", "text": "It is administered as an I.M injection over the lateral aspect of the thigh usually.", "correct": false}, {"label": "B", "text": "It acts mainly on α adrenergic receptors, and is a weak β agonist.", "correct": false}, {"label": "C", "text": "Is an inotropic agent that increases cardiac output and is used in stress tests.", "correct": true}, {"label": "D", "text": "Cannot be used in cardiogenic shock without hypotension.", "correct": false}], "correct_answer": "C. Is an inotropic agent that increases cardiac output and is used in stress tests.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a <span class=\"customMeta\" data-dictid=\"504306528f1692777199a0b2437267\">sympathomimetic</span> amine.</li>\n<li>It is mainly on β<sub>1</sub> <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors and is a weak α agonist. (Option B)</li>\n<li>Administered at 2- 8 μg/kg/min i. v. infusion. <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute heart failure.</li>\n<li>Cardiogenic shock without <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> (DOC). <strong>(Option D)</strong></li>\n<li>Stress Echocardiography. <strong>(Option C)</strong></li>\n<li>Bridge therapy for heart transplant patients.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JVSqu1qHPZUyH3dG57IU1747152351.mp3", "video": ""}, {"text": "You are an intern assisting in an operating theatre. During surgery, the patient suddenly goes into shock, showing signs of refractory hypotension. The surgeon asks you to prepare dopamine for infusion. Which of the following dosage ranges would be appropriate for the situation?", "options": [{"label": "A", "text": "0-2 mcg/kg/min", "correct": false}, {"label": "B", "text": "50-100 mcg/kg/min", "correct": false}, {"label": "C", "text": "10-50 mcg/kg/min", "correct": true}, {"label": "D", "text": "2-10 mcg/kg/min", "correct": false}], "correct_answer": "C. 10-50 mcg/kg/min", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:714px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Dosage Range</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Clinical Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>0-2 mcg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Renal <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> improvement (oliguria)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Stimulates <strong>D1 receptors</strong> primarily in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> vasculature, leading to <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> and increased <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> blood flow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>2-10 mcg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Acute Congestive heart failure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Stimulates <strong>β1 receptors</strong>, leading to increased <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output and blood pressure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>10-50 mcg/kg/min</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Moderate to severe hypotension/shock</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Predominantly acts on<strong> α1receptors,</strong> causing potent vasoconstriction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NwlK9ltdSRjGitB9bQMu1747152079.mp3", "video": ""}, {"text": "Which of the following is a false statement regarding adrenaline?", "options": [{"label": "A", "text": "Adrenaline can be given in dilution with an anaesthetic in distal phalanges.", "correct": true}, {"label": "B", "text": "Adrenaline is contraindicated in patients with severe hypertension.", "correct": false}, {"label": "C", "text": "Adrenaline is commonly used in the management of anaphylactic shock.", "correct": false}, {"label": "D", "text": "Adrenaline is recommended for use in patients with Ventricular fibrillation.", "correct": false}], "correct_answer": "A. Adrenaline can be given in dilution with an anaesthetic in distal phalanges.", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\"> </td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Epinephrine/Adrenaline </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Anaphylaxis</li>\n<li>Asthma</li>\n<li>Cardiopulmonary <span class=\"customMeta\" data-dictid=\"d343b06c7f1692777197edaea107af\">resuscitation</span> (CPR)</li>\n<li>Hemostasis</li>\n<li>Hypotension and Shock.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Tachycardia</li>\n<li>Palpitations.</li>\n<li>Tremor.</li>\n<li>Nervousness or anxiety.</li>\n<li>Hypertension</li>\n<li>Angina</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Narrow-angle glaucoma.</li>\n<li>Hypertension</li>\n<li>Angina</li>\n<li>Hyperthyroidism</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/J45KvW1NIx7J7oc0HsHA1747151890.mp3", "video": ""}, {"text": "A 45-year-old male is brought to the emergency department by paramedics after a severe anaphylactic reaction to a bee sting. The patient is in obvious distress, with signs of airway swelling, difficulty breathing, and low blood pressure. The emergency team prepares to administer adrenaline to stabilise the patient. What is the correct dilution and route of administration for adrenaline in this situation?", "options": [{"label": "A", "text": "1:1,00,000 dilution, subcutaneous injection", "correct": false}, {"label": "B", "text": "1:10,000 dilution, intravenous infusion", "correct": false}, {"label": "C", "text": "1:1000 dilution, intramuscular injection", "correct": true}, {"label": "D", "text": "1:100 dilution, intradermal injection", "correct": false}], "correct_answer": "C. 1:1000 dilution, intramuscular injection", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:736px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Dilution/Concentration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Route of Administration</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Anaphylaxis</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>First-line treatment for severe allergic reactions</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Intramuscular (IM)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Cardiac arrest</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>To restore <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> rhythm and blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>1:10,000 (0.1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Intravenous (IV)</li>\n<li>Intraosseous (IO)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Asthma</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> severe <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> attacks</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Inhalation via nebulizer</li>\n<li>Intramuscular (IM)</li>\n<li>subcutaneous (SC)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Hypotension</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>To increase blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>1:100,000 (0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Intravenous (IV) infusion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Local anesthesia</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Enhance duration and intensity of local <span class=\"customMeta\" data-dictid=\"4b83ec31581692777181547f1a89ef\">anesthetic</span> effect</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>1:200,000 to 1:100,000 (0.005 to 0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Local injection</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QjrY0YiOoH0JYb8BBHaG1747151658.mp3", "video": ""}, {"text": "A 60-year-old male patient is brought to the emergency department after a car accident. He presents with hypotension, bradycardia, and signs of shock. The medical team decides to administer norepinephrine (NE) to stabilize his blood pressure. You are an intern monitoring the patient's blood pressure and heart rate continuously. Which of the following tracings most accurately represents the effect of norepinephrine on this patient's cardiovascular system?", "options": [{"label": "A", "text": "Increased systolic blood pressure with minimal change in diastolic blood pressure.", "correct": false}, {"label": "B", "text": "Increased systolic and diastolic blood pressure with increased heart rate.", "correct": false}, {"label": "C", "text": "Increased systolic and diastolic blood pressure with decreased heart rate.", "correct": true}, {"label": "D", "text": "Decreased systolic and diastolic blood pressure with increased heart rate.", "correct": false}], "correct_answer": "C. Increased systolic and diastolic blood pressure with decreased heart rate.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vasoconstriction</strong> of arterioles and venules → increased <strong>systemic <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> resistance</strong> and <strong>diastolic blood pressure</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>β1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased heart rate</strong> (chronotropy) and <strong>increased contractility</strong> (inotropy), contributing to <strong>increased <span class=\"customMeta\" data-dictid=\"cf69f5256416927771991c21f264ae\">systolic</span> blood pressure</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Baroreceptor reflex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased blood pressure</strong> triggers <strong>baroreceptor reflex</strong> leading to <strong>vagal stimulation</strong> and <strong>reflex bradycardia</strong> to reduce heart rate.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:604px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect of Norepinephrine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Systolic BP</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased</strong> (due to β1 → ↑ <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> &amp; α1 → ↑ afterload)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diastolic BP</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased</strong> (due to α1 → ↑ <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> resistance)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Heart rate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Decreased</strong> (reflex <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> via <span class=\"customMeta\" data-dictid=\"97e403e33d169277718223c8d638e3\">baroreceptor</span> stimulation)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Total <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased</strong> (due to vasoconstriction)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pulse pressure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>May slightly increase</strong> or stay the same</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PUMgyHxi1qPWwNcpcCkk1747151500.mp3", "video": ""}, {"text": "Match the following conditions with the most appropriate drug of choice. Condition Drug of choice 1 Septic shock i Epinephrine 2 Malignant hypertension with end-organ damage ii Dopamine 3 Acute decompensated heart failure with oliguria iii Fenodolpam 4 Cardiac arrest iv Norepinephrine", "options": [{"label": "A", "text": "1-iv, 2-iii, 3-ii, 4-i", "correct": true}, {"label": "B", "text": "1-iv, 2-iii, 3-i, 4-ii", "correct": false}, {"label": "C", "text": "1-iii, 2-i, 3-iv, 4-ii", "correct": false}, {"label": "D", "text": "1-i, 2-ii, 3-iii, 4-iv", "correct": false}], "correct_answer": "A. 1-iv, 2-iii, 3-ii, 4-i", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:561px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug of choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Septic shock</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Norepinephrine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> with <span class=\"customMeta\" data-dictid=\"c36bccf76e169277718712a7cc339f\">end-organ</span> damage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fenodolpam</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dopamine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiac arrest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Epinephrine</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Norepinephrine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fenodolpam</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It acts on both <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> and <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> receptors.</li>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"25ec593008169277718360336a849a\">cardiogenic</span> shock with hypotension.\n\t\t\t\t<ul>\n<li>Stimulates ꞵ<sub>1</sub> receptors and increases the force of <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> of the heart.</li>\n<li>Stimulates 𝛼<sub>1</sub> receptors and causes <span class=\"customMeta\" data-dictid=\"3f0b42b17016927772014c586d44b7\">vasoconstriction</span> (increase in BP).</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a partial D<sub>1</sub> agonist.</li>\n<li>It is a rapidly acting <span class=\"customMeta\" data-dictid=\"8827b8fae316927772019c9b7b884f\">vasodilator</span> that should not be used for &gt;48 hours.</li>\n<li>It can be given for control of severe <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> (malignant <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> with <span class=\"customMeta\" data-dictid=\"c36bccf76e169277718712a7cc339f\">end-organ</span> damage).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dopamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Epinephrine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It acts on D<sub>1</sub> and D<sub>2</sub> receptors.</li>\n<li>It acts on both <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> and <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> receptors except ꞵ<sub>2</sub>.</li>\n<li><strong>Dose-dependent action</strong>.\n\t\t\t\t<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"da8747dcd51692777185e1ed0554cc\">decompensated</span> <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> with oliguria.</li>\n<li>Cardiogenic and <span class=\"customMeta\" data-dictid=\"39f67d7dde16927771985d3952058d\">septic</span> shock.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It acts on all receptors with a weak action on ꞵ<sub>3 </sub>receptors.</li>\n<li>Uses:\n\t\t\t\t<ul>\n<li>Anaphylactic shock.</li>\n<li>Brittle asthma.</li>\n<li>Cardiac arrest.</li>\n<li>Along with local anesthetics.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hRBBRbzm0E3J69oZPviE1745660820.mp3", "video": ""}, {"text": "β2 receptors are present in all of the following organs except?", "options": [{"label": "A", "text": "Blood vessels.", "correct": false}, {"label": "B", "text": "Uterus.", "correct": false}, {"label": "C", "text": "Urinary bladder.", "correct": true}, {"label": "D", "text": "Bronchi.", "correct": false}], "correct_answer": "C. Urinary bladder.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:648px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>β1 </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>β2 </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>β3 </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Location</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart and JG cells.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bronchi, blood vessels, uterus, liver, GIT, <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> tract, and eye.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adipose tissue and <span class=\"customMeta\" data-dictid=\"80d318a6701692777186805934d86a\">detrusor</span> muscle of the <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> bladder.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effects on stimulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>↑ Heart rate.</li>\n<li>↑ <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">Conduction</span> rate.</li>\n<li>↑ Force of contraction.</li>\n<li>↑ <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">Renin</span> release (↑ BP).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tremors.</li>\n<li>Hyperglycemia.</li>\n<li>Bronchodilation.</li>\n<li>Vasodilation.</li>\n<li>Tocolysis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lipolysis.</li>\n<li>Relaxation of the <span class=\"customMeta\" data-dictid=\"80d318a6701692777186805934d86a\">detrusor</span> muscle.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GGv7QeTaXj5mRc6Oy0Hq1747151291.mp3", "video": ""}, {"text": "A patient is diagnosed with pheochromocytoma. Which drug can help improve the patient’s symptoms by inhibiting tyrosine hydroxylase?", "options": [{"label": "A", "text": "Methyldopa", "correct": false}, {"label": "B", "text": "Clonidine", "correct": false}, {"label": "C", "text": "Metyrosine", "correct": true}, {"label": "D", "text": "Phenoxybenzamine", "correct": false}], "correct_answer": "C. Metyrosine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Pd3wekWA2rOpxn8KvZc01734421127.png", "https://image.prepladder.com/content/8SJwJosi5SjFOKrHOVYp1734772621.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tMVy1UQIWJaQ9kbY15Pb1747151160.mp3", "video": ""}, {"text": "A patient is diagnosed with benign prostatic hyperplasia (BPH). He is prescribed tamsulosin. Which of the following receptors does this drug act on?", "options": [{"label": "A", "text": "α 1A", "correct": true}, {"label": "B", "text": "α 1B", "correct": false}, {"label": "C", "text": "α 2A", "correct": false}, {"label": "D", "text": "α 2C", "correct": false}], "correct_answer": "A. α 1A", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>1 </sub></strong><strong>(G</strong><strong><sub>q</sub></strong><strong> type of GPCR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>1A</sub></strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>1B (Option B)</sub></strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Present in the <strong>iris and internal urethral <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> (IUS).</strong></li>\n<li>Effects: <span class=\"customMeta\" data-dictid=\"d37f6ac51016927771932ba05a49bc\">Mydriasis</span> &amp; smooth muscle contraction.</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Present in the <strong>blood vessels</strong>.</li>\n<li>Causes <span class=\"customMeta\" data-dictid=\"3f0b42b17016927772014c586d44b7\">vasoconstriction</span> (increased BP).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>2 </sub></strong><strong>(G</strong><strong><sub>i</sub></strong><strong> type of GPCR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>2A </sub></strong><strong>(Presynaptic autoreceptor) </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>2B </sub></strong><strong>(Postsynaptic receptor)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>α</strong><strong><sub>2C </sub></strong><strong>(Extrasynaptic receptor) (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Presynaptic autoreceptor (It is an <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> autoreceptor stimulated by <span class=\"customMeta\" data-dictid=\"155371e9941692777193b48666ce0a\">norepinephrine</span> and inhibits its own release).</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Postsynaptic receptor.</li>\n<li>Similar functions like α<sub>1</sub> receptors.</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Present in platelets and duodenum.</li>\n<li>Effects: Decrease in <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> and <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> attachment.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PtoDfrvl4y4hqlaaTnkI1747150982.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 31 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old male patient with a history of hyperthyroidism is diagnosed with a brain tumor and is scheduled for neurosurgery. Thiopentone has been chosen as the induction agent for this surgery. Which of the following is an incorrect statement about Thiopentone?", "options": [{"label": "A", "text": "Thiopentone decreases intracranial pressure, making it suitable for neurosurgical procedures", "correct": false}, {"label": "B", "text": "Porphyria is a relative contraindication for thiopentone", "correct": true}, {"label": "C", "text": "The mechanism for termination of action is by redistribution from brain to fat cells", "correct": false}, {"label": "D", "text": "Thiopentone has antithyroid properties and thus is an agent of choice for hyperthyroid patients", "correct": false}], "correct_answer": "B. Porphyria is a relative contraindication for thiopentone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:404px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Absolute </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Relative</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Porphyria</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Heart Blocks</li>\n<li>Hypotension</li>\n<li>Asthma</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Termination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Redistribution from the brain to fat and muscle tissues</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolised in the liver by hydroxylation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excreted by the kidneys</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Bp5IGjG2Mly03Br0ITUS1749193461.mp3", "video": ""}, {"text": "A 45 year old male undergoes a minor surgical procedure for lipoma excision under local anesthesia with bupivacaine. Shortly after administration, he complains of tinnitus, dizziness and a metallic taste in his mouth. What is the most appropriate treatment for this patient's condition?", "options": [{"label": "A", "text": "Intravenous atropine", "correct": false}, {"label": "B", "text": "Intravenous epinephrine", "correct": false}, {"label": "C", "text": "20% lipid emulsion therapy", "correct": true}, {"label": "D", "text": "Intravenous sodium bicarbonate", "correct": false}], "correct_answer": "C. 20% lipid emulsion therapy", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Toxicity</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lipophilic nature leads to slow dissociation/prolonged blocking from <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> sodium channels.</li>\n<li>Persistent channel <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> causes <span class=\"customMeta\" data-dictid=\"fa914a0d95169277718542753b513d\">cumulative</span> cardiotoxicity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CNS: Tinnitus, <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> taste, dizziness, seizures.</li>\n<li>Cardiovascular: Bradycardia, dysrhythmias, asystole.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>20% <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> <span class=\"customMeta\" data-dictid=\"424b9f12511692777187541c585eb9\">emulsion</span> therapy acts as a \"lipid sink\" to reduce tissue concentration of bupivacaine.</li>\n<li>Effective <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> management is vital, especially in the presence of acidosis, hypercarbia, or hypoxemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exacerbating Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acidosis, hypercarbia, <span class=\"customMeta\" data-dictid=\"9f81027f0116927771892823259e5d\">hypoxemia</span> can worsen <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> toxicity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male patient with a history of chronic kidney disease and liver cirrhosis is scheduled for elective abdominal surgery. The anesthesiologist must choose an appropriate muscle relaxant for intubation and intraoperative muscle relaxation. Considering the patient's comorbidities, the anesthesiologist is evaluating the use of cisatracurium instead of atracurium. Which of the following statements is true regarding Atracurium?", "options": [{"label": "A", "text": "Metabolised by Hoffman elimination only", "correct": false}, {"label": "B", "text": "Dose-dependent histamine release", "correct": true}, {"label": "C", "text": "Preferred muscle relaxant in liver/ kidney disease", "correct": false}, {"label": "D", "text": "Made of only one isomer", "correct": false}], "correct_answer": "B. Dose-dependent histamine release", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Atracurium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cisatracurium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Mixture of &gt;10 isomers</li>\n<li>Metabolized by Hoffmann <span class=\"customMeta\" data-dictid=\"86c65ffa40169277718763f4072c2f\">elimination</span> and <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> esterase</li>\n<li><strong>Dose-dependent <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> release ➞ <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> (Option B)</strong></li>\n<li>Should be avoided in patients with kidney/ liver disease, as its toxic <span class=\"customMeta\" data-dictid=\"fceb6bf8d01692777192b8b179f554\">metabolite</span> laudanosine gets accumulated ➞ <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> ➞ seizures</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Made of one isomer</strong> <strong>(Option D)</strong></li>\n<li><strong>100% of the drug is metabolized by Hofmann elimination</strong> <strong>(Option A)</strong></li>\n<li>No <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> release</li>\n<li><strong>Safe in patients with kidney/ liver disease (Option C).</strong></li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male patient is brought to the emergency department for an urgent intubation due to respiratory failure. The anesthesiologist decides to use succinylcholine to facilitate rapid sequence intubation. Which of the following statements is false regarding succinylcholine?", "options": [{"label": "A", "text": "Toxicity causes diaphragm paralysis", "correct": false}, {"label": "B", "text": "Toxicity causes hyperkalemia", "correct": false}, {"label": "C", "text": "Contraindicated in muscular dystrophy", "correct": false}, {"label": "D", "text": "Drug of choice in stroke and hemiplegia", "correct": true}], "correct_answer": "D. Drug of choice in stroke and hemiplegia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Toxicity of succinylcholine:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diaphragm <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> ➞ Scoline <span class=\"customMeta\" data-dictid=\"22b9ee5b2b16927771814b5d8d34ac\">apnea</span> <strong>(Option A)</strong></li>\n<li>Hyperkalemia <strong>(Option B)</strong>\n<ul>\n<li>Due to <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> release ➞ <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrest</li>\n<li>Increased in trauma, burns, rhabdomyolysis</li>\n</ul>\n</li>\n<li>Malignant hyperthermia\n\t\t\t\t<ul>\n<li>Treated by Dantrolene</li>\n</ul>\n</li>\n<li>Histamine release</li>\n<li>SA <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> partial <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> leads to <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> , <span class=\"customMeta\" data-dictid=\"2e60fc18fc1692777190e6a077b17b\">junctional rhythm</span> - treatment: i/v atropine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Muscle <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">dystrophy</span> <strong>(Option C)</strong></li>\n<li>Neurological disease\n\t\t\t\t<ul>\n<li>Hemiplegia</li>\n<li>Stroke <strong>(Option D)</strong></li>\n</ul>\n</li>\n<li>Contraindicated in head injury, glaucoma\n\t\t\t\t<ul>\n<li>Increases ICP, IOP</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old female undergoing elective laparoscopic cholecystectomy develops muscle fasciculations followed by flaccid paralysis after a neuromuscular blocking agent is administered. Despite neostigmine administration, the muscle relaxation persists. Which muscle relaxant was administered?", "options": [{"label": "A", "text": "Suxamethonium", "correct": true}, {"label": "B", "text": "Pancuronium", "correct": false}, {"label": "C", "text": "Pipecuronium", "correct": false}, {"label": "D", "text": "Vecuronium", "correct": false}], "correct_answer": "A. Suxamethonium", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:721px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Depolarizing Blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Depolarizing Blockers</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Suxamethonium/ succinylcholine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Curonium, curium, curare</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase1</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Opening of Nm <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (like Ach)\n\t\t\t\t<ul>\n<li>Initial muscle contraction- fasciculation</li>\n<li>Depolarizing SMR</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Enters into phase 2</strong></p>\n<ul>\n<li>Desensitization of the Nm <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> ➞ <span class=\"customMeta\" data-dictid=\"d28003a82c1692777202475273e346\">flaccid</span> <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> of the muscle</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitively block Nm <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> of Ach</p>\n<ul>\n<li>They are non-depolarizing and cause <span class=\"customMeta\" data-dictid=\"d28003a82c1692777202475273e346\">flaccid</span> paralysis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Role of</strong></p>\n<p><strong>Neostigmine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neostigmine <strong>cannot</strong> reverse the effect</p>\n<p>of succinylcholine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For <span class=\"customMeta\" data-dictid=\"82343f61171692777197b4a08bc719\">reversal</span> of NDMR:</p>\n<p>increase Ach</p>\n<p>o Neostigmine</p>\n<p>o Edrophonium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial</strong></p>\n<p><strong>Fasciculations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Postoperative</strong></p>\n<p><strong>myalgia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cold Temperature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase the effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decrease the effect</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Muscle sensitivity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st to paralyze: Neck muscle</p>\n<p>Last to paralyze: Diaphragm</p>\n<p>(Most resistant, 1st to recover)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st: Fingers</p>\n<p>Last: Diaphragm</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following local anaesthetics is used to diagnose pseudocholinesterase deficiency?", "options": [{"label": "A", "text": "Ropivacaine", "correct": false}, {"label": "B", "text": "Bupivacaine", "correct": false}, {"label": "C", "text": "Etidocaine", "correct": false}, {"label": "D", "text": "Dibucaine", "correct": true}], "correct_answer": "D. Dibucaine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3gu78Op3pFU3EorPqU401749194007.mp3", "video": ""}, {"text": "In the context of differential sensitivity of nerve fibers to local anaesthetics, which of the following sequences correctly represents the order in which different types of nerve fibres are blocked, starting from the most sensitive to the least sensitive?", "options": [{"label": "A", "text": "Type A alpha, Type A beta, Type A gamma, Type A delta, Type C", "correct": false}, {"label": "B", "text": "Type A delta, Type A gamma, Type A beta, Type A alpha,Type C", "correct": true}, {"label": "C", "text": "Type A delta, Type A alpha, Type A beta, Type A gamma, Type C", "correct": false}, {"label": "D", "text": "Type C, Type A gamma, Type A delta, Type A beta, Type A alpha", "correct": false}], "correct_answer": "B. Type A delta, Type A gamma, Type A beta, Type A alpha,Type C", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/MqgzgsSSLuNbi2BEoQVh1734420199.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vQE2PmN9rML5M1LYVMG41749193911.mp3", "video": ""}, {"text": "A 12-year-old patient was sedated for more than 48 hours following status epilepticus. He developed refractory bradycardia, hyperlipidemia, and renal failure. Arterial blood gas (ABG) analysis showed metabolic acidosis. Which of the following sedatives is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Midazolam", "correct": false}, {"label": "B", "text": "Propofol", "correct": true}, {"label": "C", "text": "Dexmedetomidine", "correct": false}, {"label": "D", "text": "Fentanyl", "correct": false}], "correct_answer": "B. Propofol", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M2SIh1C4pYUCu6nLejhl1749193748.mp3", "video": ""}, {"text": "A 40-year-old patient is administered an intermediate-acting amide as a local anesthetic during a minor surgical procedure on the upper extremity. Shortly after administration, the patient develops cyanosis and complains of shortness of breath. Which of the following is most likely the local anesthetic based on the above symptoms?", "options": [{"label": "A", "text": "Prilocaine", "correct": true}, {"label": "B", "text": "Mepivacaine", "correct": false}, {"label": "C", "text": "Lidocaine", "correct": false}, {"label": "D", "text": "Bupivacaine", "correct": false}], "correct_answer": "A. Prilocaine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:558px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Local Anaesthetic</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ultra Short</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chloroprocaine (<strong>shortest</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Short</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Procaine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lidocaine, Prilocaine, Mepivacaine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Long</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bupivacaine, Ropivacaine, Etidocaine, Tetracaine, <span class=\"customMeta\" data-dictid=\"472b26698d1692777186792052f0d9\">Dibucaine</span> (<strong>longest</strong>)</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:603px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amides</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esters</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Physical property</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stable solution</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unstable, structurally similar to PABA.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>By liver</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Esterase enzyme</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exceptions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Artikane by esterase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cocaine in liver</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prilocaine, lignocaine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Procaine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6uplRX4MkcB7okYx6Ll71749193579.mp3", "video": ""}, {"text": "A 34-year-old woman is scheduled for a laparoscopic cholecystectomy. During the preoperative evaluation, the anesthesiologist explains the different types of anaesthetics that will be used and points at a cylinder having a blue body and white shoulder, along with a fast-acting IV drug. What are these anaesthetic agents?", "options": [{"label": "A", "text": "Nitrous oxide + Oxygen; Propofol", "correct": true}, {"label": "B", "text": "Cyclopropane; Fentanyl", "correct": false}, {"label": "C", "text": "Carbon dioxide; Ketamine", "correct": false}, {"label": "D", "text": "Nitrous oxide + Oxygen; Midazolam", "correct": false}], "correct_answer": "A. Nitrous oxide + Oxygen; Propofol", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/oSUDnp0mVaANfXod9xRW1734419926.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:485px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Gas</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Colour Coding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\"><strong>Pin Index Safety System</strong></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Air</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Grey body + black/white shoulder</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>1,5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Oxygen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Black body + white shoulder</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>2,5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Nitrous Oxide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Blue</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>3,5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Entonox (Nitrous <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">Oxide</span> + Oxygen) (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Blue body + white shoulder</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p style=\"text-align:center\">7</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Carbon <span class=\"customMeta\" data-dictid=\"0bd01a042116927771868e3482910e\">Dioxide</span> (&gt;7.5%)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Grey</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>1,6</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Carbon <span class=\"customMeta\" data-dictid=\"0bd01a042116927771868e3482910e\">Dioxide</span> (&lt;7.5%)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Grey</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>2,6</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Cyclopropane</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Orange</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:bottom\">\n<p>3,6</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/y99deHUUVIyTcFoZZxTt1749192294.mp3", "video": ""}, {"text": "Which of the following statements about isoflurane is correct?", "options": [{"label": "A", "text": "Isoflurane primarily causes a drop in blood pressure through cardiac depression", "correct": false}, {"label": "B", "text": "Isoflurane maintains cardiac output while causing vasodilation", "correct": true}, {"label": "C", "text": "Isoflurane is known to provoke seizures, making it unsuitable for patients undergoing neurosurgery", "correct": false}, {"label": "D", "text": "Isoflurane causes significant metabolic byproducts, leading to renal and hepatic toxicity.", "correct": false}], "correct_answer": "B. Isoflurane maintains cardiac output while causing vasodilation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CVS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Decrease in BP - due to <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> <strong>(Option A)</strong></li>\n<li>CO is well maintained - suitable for patients with myocardial <span class=\"customMeta\" data-dictid=\"80feaae4b31692777190ea1ba3fc25\">insufficiency</span> <strong>(Option B)</strong></li>\n<li>HR is increased due to <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tachycardia</li>\n<li><strong>Dilates coronaries - possibility of <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> steal syndrome</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>RS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Respiratory depression</li>\n<li>Increased secretions</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uterus and Skeletal Muscles</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscle Relaxation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ocular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pupils do not <span class=\"customMeta\" data-dictid=\"7e9bc153d616927771866a8608d1a5\">dilate</span> and light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is not lost.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Negligible - No <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> or hepatotoxicity</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SSIpla0cHmmdFvCDmsap1749193298.mp3", "video": ""}, {"text": "A 45-year-old male patient with a history of asthma presents to the operating room for elective surgery. Halothane is used as the primary anaesthetic agent. During the induction phase, the patient suddenly develops ventricular arrhythmias. What is the most likely mechanism underlying the ventricular arrhythmias induced by halothane in this patient?", "options": [{"label": "A", "text": "Direct myocardial depression", "correct": false}, {"label": "B", "text": "Inhibition of catecholamine release", "correct": false}, {"label": "C", "text": "Sensitization of the myocardium to catecholamines", "correct": true}, {"label": "D", "text": "Potentiation of calcium influx into cardiac myocytes", "correct": false}], "correct_answer": "C. Sensitization of the myocardium to catecholamines", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8WTZ7nwRwcAyil1XC9yc1734420127.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CVS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Decrease in BP due to <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> depression</li>\n<li>CO is <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> with deepening anesthesia</li>\n<li>HR is reduced</li>\n<li>Sensitize the heart to the <span class=\"customMeta\" data-dictid=\"e642b199ae1692777182a78aca6335\">arrhythmogenic</span> action of adrenaline/noradrenaline</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>RS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Respiratory depression</li>\n<li>Bronchodilation - <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for asthmatics</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GI/GU</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits intestinal and <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> contractions</p>\n<p>↓BP → ↓GFR → ↓ <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> formation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>By liver - Hepatotoxic</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YtmjOIh3ut35ndrB8smD1749193166.mp3", "video": ""}, {"text": "A 45-year-old male is undergoing surgery for an abdominal hernia repair. Cyclopropane is chosen as the anaesthetic agent. During the procedure, electrocautery is used to control bleeding. Due to concerns about cyclopropane's high flammability, the anesthesiologist decides to discontinue its administration. The patient experiences a drop in blood pressure. What is the most likely cause of the patient's hypotension?", "options": [{"label": "A", "text": "An equipment malfunction resulted in inadequate delivery of oxygen during surgery", "correct": false}, {"label": "B", "text": "Sudden withdrawal of cyclopropane led to a sharp decrease in sympathetic nervous system activity", "correct": true}, {"label": "C", "text": "The patient experienced a common side effect of the electrocautery", "correct": false}, {"label": "D", "text": "The patient had an allergic reaction to cyclopropane", "correct": false}], "correct_answer": "B. Sudden withdrawal of cyclopropane led to a sharp decrease in sympathetic nervous system activity", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eYfgWpnk6Feo8UsLAa1L1749193055.mp3", "video": ""}, {"text": "Entonox, used for analgesia during painful procedures, exhibits the Poynting effect. Which of the following statements best describes the Poynting effect in Entonox?", "options": [{"label": "A", "text": "It causes the individual properties of nitrogen and oxygen to intensify when combined", "correct": false}, {"label": "B", "text": "It results in the production of a gas mixture that behaves differently from its individual components", "correct": true}, {"label": "C", "text": "It increases the likelihood of adverse effects when administering Entonox", "correct": false}, {"label": "D", "text": "It leads to the rapid separation of nitrogen and oxygen at high pressures", "correct": false}], "correct_answer": "B. It results in the production of a gas mixture that behaves differently from its individual components", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MkFr4uZFgzm5jiIegsJz1749192803.mp3", "video": ""}, {"text": "A 40-year-old male with a history of substance abuse presents for a wisdom tooth extraction. The patient is known to abuse nitrous oxide recreationally. His medical history is otherwise unremarkable. The anesthesiologist is considering the use of nitrous oxide for sedation. Which of the following complications should the anesthesiologist be most concerned about for this patient?", "options": [{"label": "A", "text": "Malignant Hyperthermia", "correct": false}, {"label": "B", "text": "Hepatotoxicity", "correct": false}, {"label": "C", "text": "Vitamin B 12 Deficiency", "correct": true}, {"label": "D", "text": "Renal toxicity", "correct": false}], "correct_answer": "C. Vitamin B 12 Deficiency", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/toMDN4GEjbHWBEeIsCwN1734420051.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nOuCg6gQ9yeIPg2kBZTg1749192691.mp3", "video": ""}, {"text": "A 45-year-old male presents to the emergency department with sudden onset sharp chest pain and shortness of breath. On examination, he has decreased breath sounds on the left side, and chest X-ray confirms left-sided pneumothorax. The patient is scheduled for an urgent chest tube insertion under general anaesthesia. Which of the following inhaled anaesthetics is contraindicated in this patient?", "options": [{"label": "A", "text": "Sevoflurane", "correct": false}, {"label": "B", "text": "Isoflurane", "correct": false}, {"label": "C", "text": "Desflurane", "correct": false}, {"label": "D", "text": "Nitrous oxide", "correct": true}], "correct_answer": "D. Nitrous oxide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:497px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhaled Anaesthetic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on Air Spaces</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use in Pneumothorax</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nitrous oxide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Expands air-filled cavities</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contraindicated</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sevoflurane (Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No significant effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Isoflurane (Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No significant effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Desflurane (Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No significant effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WS2ZGOc7lb2Tc6htpv8F1748866660.mp3", "video": ""}, {"text": "Match each inhalation agent with its corresponding blood/gas partition coefficient: Inhaled anaesthetic B/G partition coefficient a) Sevoflurane 1) 0.47 b) Isoflurane 2) 0.68 c) Desflurane 3) 1.4 d) Nitrous oxide 4) 0.42", "options": [{"label": "A", "text": "a-4, b-1, c-3, d-2 ", "correct": false}, {"label": "B", "text": "a-3, b-4, c-1, d-2", "correct": false}, {"label": "C", "text": "a-2, b-3, c-4, d-1", "correct": true}, {"label": "D", "text": "a-3, b-2, c-1, d-4", "correct": false}], "correct_answer": "C. a-2, b-3, c-4, d-1", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/J78tu2Y6LeB5naL1p9iZ1734419981.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:475px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B/G <span class=\"customMeta\" data-dictid=\"25c5ca7c4516927771942bb8637e83\">Partition</span> Coefficient</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhalation anaesthetic</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lowest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Desflurane (Fastest acting)- 0.42</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Highest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ether (Slowest acting)- 12.1</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HKrRiAsxNVHVxU3UmL3j1749192550.mp3", "video": ""}, {"text": "A 25-year-old male presents to the emergency department with acute onset right lower quadrant abdominal pain, nausea, and vomiting. On examination, he has right lower quadrant rebound tenderness and guarding. The doctor decides to take him up for an emergency surgery. Which inhalation anaesthetic would be best for induction in this patient based on its MAC values and blood gas solubility?", "options": [{"label": "A", "text": "Nitrous oxide", "correct": false}, {"label": "B", "text": "Sevoflurane", "correct": true}, {"label": "C", "text": "Desflurane", "correct": false}, {"label": "D", "text": "Halothane", "correct": false}], "correct_answer": "B. Sevoflurane", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/yMhmYE85sSSDfJeZr6Ik1734419854.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MAC Value</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhalation anaesthetic</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lowest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Halothane (Most potent) -0.75</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Highest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nitrous <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> (Least potent) -105</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AWQsFRsQnEKcc3g5rFqK1749192453.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 28 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Reversal of the muscle relaxant by Vecuronium/rocuronium in patient with Renal failure is normally done by:", "options": [{"label": "A", "text": "Sugammadex", "correct": false}, {"label": "B", "text": "Neostigmine", "correct": true}, {"label": "C", "text": "Physostigmine", "correct": false}, {"label": "D", "text": "Rivastigmine", "correct": false}], "correct_answer": "B. Neostigmine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Neostig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Sugammadex is used as a reversal agent for which of the following NMDA?", "options": [{"label": "A", "text": "Rocuronium", "correct": true}, {"label": "B", "text": "Mivacurium", "correct": false}, {"label": "C", "text": "Atracurium", "correct": false}, {"label": "D", "text": "Scoline", "correct": false}], "correct_answer": "A. Rocuronium", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Rocuroniu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Most potent opioid is?", "options": [{"label": "A", "text": "Fentanyl", "correct": true}, {"label": "B", "text": "Morphine", "correct": false}, {"label": "C", "text": "Pentazocine", "correct": false}, {"label": "D", "text": "Pethidine", "correct": false}], "correct_answer": "A. Fentanyl", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which inhalational anesthetic agents can potentially induce hepatitis with repeated administration?", "options": [{"label": "A", "text": "Halothane", "correct": true}, {"label": "B", "text": "Isoflurane", "correct": false}, {"label": "C", "text": "Sevoflurane", "correct": false}, {"label": "D", "text": "Ether", "correct": false}], "correct_answer": "A. Halothane", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A.\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following IV anaesthetic agent is used for day care surgery?", "options": [{"label": "A", "text": "Ketamine", "correct": false}, {"label": "B", "text": "Thiopentone", "correct": false}, {"label": "C", "text": "Propofol", "correct": true}, {"label": "D", "text": "Etomidate", "correct": false}], "correct_answer": "C. Propofol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "During the surgery of a 40-year-old patient, anesthesia is administered along with other agents to enhance the effects of anesthesia and minimize any negative consequences. Which of the options below refers to the muscle relaxant with the shortest duration of action and is commonly used for rapid sequence induction?", "options": [{"label": "A", "text": "Tubocurarine", "correct": false}, {"label": "B", "text": "Succinylcholine", "correct": true}, {"label": "C", "text": "Pancuronium", "correct": false}, {"label": "D", "text": "Atracurium", "correct": false}], "correct_answer": "B. Succinylcholine", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Agent</strong></p>\n</td>\n<td>\n<p><strong>Purpose</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Benzodiazepines</p>\n</td>\n<td>\n<p>Provide <span class=\"customMeta\" data-dictid=\"b81cee1b5f16927771987099f651a0\">sedation</span> and anxiolysis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Opioids</p>\n</td>\n<td>\n<p>Provide <span class=\"customMeta\" data-dictid=\"66ccee483016927771810c2c295d74\">analgesia</span> and reduce <span class=\"customMeta\" data-dictid=\"a489e669011692777190af3dd98ed4\">intraoperative</span> pain</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Propofol</p>\n</td>\n<td>\n<p>Induce and maintain anesthesia</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Inhalational agents</p>\n</td>\n<td>\n<p>Maintain general <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> during surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Neuromuscular blockers</p>\n</td>\n<td>\n<p>Facilitate muscle <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> during surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antiemetics</p>\n</td>\n<td>\n<p>Prevent or treat <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Anticholinergics</p>\n</td>\n<td>\n<p>Prevent <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> and reduce <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> secretions</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Local anesthetics</p>\n</td>\n<td>\n<p>Provide regional <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> or <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> pain control</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Corticosteroids</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and prevent allergic reactions</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nonsteroidal anti-inflammatory drugs (NSAIDs)</p>\n</td>\n<td>\n<p>Provide <span class=\"customMeta\" data-dictid=\"66ccee483016927771810c2c295d74\">analgesia</span> and reduce inflammation</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 16 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 65-year-old male presents with a recent diagnosis of advanced non-small cell lung cancer (NSCLC). The oncologist decides to initiate treatment with pemetrexed. The patient has a history of COPD and hypertension, which are well-controlled with medication. Which of the following best describes the mechanism of action of pemetrexed in the treatment of non-small cell lung cancer (NSCLC)?", "options": [{"label": "A", "text": "Inhibits thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase, thereby disrupting DNA and RNA synthesis.", "correct": true}, {"label": "B", "text": "Binds to tubulin, inhibiting microtubule formation and causing cell cycle arrest in the M phase.", "correct": false}, {"label": "C", "text": "Acts as an alkylating agent, causing cross-linking of DNA strands and preventing DNA replication.", "correct": false}, {"label": "D", "text": "Inhibits topoisomerase II, leading to DNA strand breaks and apoptosis.", "correct": false}], "correct_answer": "A. Inhibits thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase, thereby disrupting DNA and RNA synthesis.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/njgxOf8EoexxEFWLjvSE1736435102.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:900px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Folate Analogue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pemetrexed </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of</p>\n<ul>\n<li>Thymidylate synthase</li>\n<li>Dihydrofolate reductase</li>\n<li>Glycinamide <span class=\"customMeta\" data-dictid=\"d74fcef45b16927771979689961be7\">ribonucleotide</span> <span class=\"customMeta\" data-dictid=\"bc9d05c4c71692777203e7c30039d1\">formyltransferase</span> (GARFT)</li>\n</ul>\n<p>→ <span class=\"customMeta\" data-dictid=\"7061e0e0051692777186ba9c5f27df\">depletion</span> of <span class=\"customMeta\" data-dictid=\"94a2f0970016927771932885a3d362\">nucleotide</span> pools essential for DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and repair.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mesothelioma</li>\n<li>Non-small cell lung cancer (NSCLC)</li>\n<li>In combination with <span class=\"customMeta\" data-dictid=\"ca71207b36169277718438d09cbda0\">cisplatin</span> for <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> pleural mesothelioma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methotrexate </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">dihydrofolate</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> - prevents the formation of THF.</p>\n<p>Disrupts DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and cell proliferation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute lymphoblastic <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (ALL)</li>\n<li>Non-Hodgkin lymphoma</li>\n<li>Osteosarcoma</li>\n<li>Gestational trophoblastic neoplasia</li>\n<li>Rheumatoid arthritis</li>\n<li>Psoriasis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Raltitrexed </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"e34386023d169277720036d8bccc88\">thymidylate</span> <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> - <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with DNA synthesis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Colorectal cancer.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pralatrexate </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitive <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> of</p>\n<ul>\n<li>dihydrofolate reductase</li>\n<li>thymidylate synthase,</li>\n</ul>\n<p>→ disrupting <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and inhibiting DNA synthesis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Relapsed or <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> T-cell <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">lymphoma</span> (PTCL).</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true about Eribulin?", "options": [{"label": "A", "text": "It is less affected by the PGP efflux pump", "correct": true}, {"label": "B", "text": "Used in colorectal cancer", "correct": false}, {"label": "C", "text": "Inhibits depolymerization of microtubule", "correct": false}, {"label": "D", "text": "Forms toxic metabolite called SN-38 causing GIT damage", "correct": false}], "correct_answer": "A. It is less affected by the PGP efflux pump", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male patient undergoing treatment for testicular cancer develops pruritic, erythematous bands on his arms and back. What is the mechanism of action of the drug that causes this cutaneous presentation?", "options": [{"label": "A", "text": "Generates free radicals and induces DNA cleavage via deoxyribose ring damage", "correct": true}, {"label": "B", "text": "Inhibits ribonucleotide reductase", "correct": false}, {"label": "C", "text": "Prevents polymerization and disrupts microtubule formation", "correct": false}, {"label": "D", "text": "Inhibits topoisomerase II", "correct": false}], "correct_answer": "A. Generates free radicals and induces DNA cleavage via deoxyribose ring damage", "question_images": ["https://image.prepladder.com/content/yPbu2JIVYiMSnWZnKzA31736435585.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 62-year-old female patient, receiving treatment with daunorubicin for breast cancer, presents with symptoms of fatigue, shortness of breath, and chest pain. An echocardiogram shows decreased left ventricular ejection fraction. Which of the following agents should be administered to prevent further cardiac damage?", "options": [{"label": "A", "text": "Penicillamine", "correct": false}, {"label": "B", "text": "Dexrazoxane", "correct": true}, {"label": "C", "text": "Ethylenediaminetetraacetic acid (EDTA)", "correct": false}, {"label": "D", "text": "Dimercaprol", "correct": false}], "correct_answer": "B. Dexrazoxane", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/K4zuD1Pmj84x44TtG7571747764219.mp3", "video": ""}, {"text": "A 45 y/o female was recently diagnosed with acute promyelocytic leukemia (APML). She has been undergoing treatment for the same for the past 1 month. She now presents with sudden dyspnea, tachypnea &amp;amp; dry cough. O/E cyanosis is present. The doctor suspects ARDS. Her CBC showed elevated WBC counts as well. Which of the following drugs is responsible for the patient's condition?", "options": [{"label": "A", "text": "All-trans retinoic acid (ATRA)", "correct": true}, {"label": "B", "text": "Methotrexate", "correct": false}, {"label": "C", "text": "Cyclophosphamide", "correct": false}, {"label": "D", "text": "Azathioprine", "correct": false}], "correct_answer": "A. All-trans retinoic acid (ATRA)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/pqnDGrQ5i7f5TF2M3gjb1736435535.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30 y/o male came with h/o testicular cancer. He underwent chemotherapy 6 months ago for the same. He now presents with progressive dyspnea and a dry cough for the past 3 months. Pulmonary function tests reveal restrictive lung disease with decreased lung volumes. Chest Xray shows diffuse basilar infiltrates and Pulmonary fibrosis. Which of the following chemotherapy drugs is most likely responsible for the patient's condition?", "options": [{"label": "A", "text": "Cisplatin", "correct": false}, {"label": "B", "text": "Etoposide", "correct": false}, {"label": "C", "text": "Bleomycin", "correct": true}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "C. Bleomycin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kdO6QY2ThgphOkdKC7wq1736435451.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male patient with a known history of Crigler-Najjar syndrome type I is diagnosed with metastatic colon cancer. The oncology team is planning his treatment regimen, which includes various anticancer drugs. Which of the following anti-cancer drugs is contraindicated in this patient?", "options": [{"label": "A", "text": "Irinotecan", "correct": true}, {"label": "B", "text": "Topotecan", "correct": false}, {"label": "C", "text": "Etoposide", "correct": false}, {"label": "D", "text": "5 Fluro-Uracil", "correct": false}], "correct_answer": "A. Irinotecan", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/mz4dyNsol71CzvV8JzL61736435386.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 y/o woman presents with a new diagnosis of metastatic breast cancer. Her oncologist decides to initiate treatment with a drug that inhibits microtubules. Considering her condition and the available microtubule- inhibiting drugs, the oncologist discusses the options, including vincristine, vinblastine, paclitaxel, and docetaxel. Which of the following statements is true for microtubule-inhibiting anti-cancer drugs?", "options": [{"label": "A", "text": "Vincristine &amp;amp; vinblastine are both vinca alkaloids that inhibit tubulin polymerization, thereby preventing the formation of microtubules.", "correct": true}, {"label": "B", "text": "Vincristine &amp;amp; vinblastine are both equally neurotoxic.", "correct": false}, {"label": "C", "text": "Paclitaxel and docetaxel both destabilize microtubules by inhibiting tubulin assembly, leading to mitotic spindle dysfunction.", "correct": false}, {"label": "D", "text": "Paclitaxel and docetaxel are both contraindicated in liver disease", "correct": false}], "correct_answer": "A. Vincristine &amp; vinblastine are both vinca alkaloids that inhibit tubulin polymerization, thereby preventing the formation of microtubules.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Vinca Alkaloids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Taxanes</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Inhibit <span class=\"customMeta\" data-dictid=\"1346ac97b61692777196b91eff8228\">polymerization</span> of microtubules</li>\n<li>Inhibit the formation of spindle</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Inhibit <span class=\"customMeta\" data-dictid=\"b05a983ef116927771865c58c70d2e\">depolymerization</span> of microtubules</li>\n<li>Inhibit movement or over-stabilization of spindle</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Drugs</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Vincristine</li>\n<li>Vinblastine</li>\n<li>Vinorelbine</li>\n<li>Vindesine</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Paclitaxel</li>\n<li>Docetaxel</li>\n<li>Cabazitaxel</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Toxicity</strong></p>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Highly neurotoxic</li>\n<li>Causes <span class=\"customMeta\" data-dictid=\"14bba9af561692777194c8cadacf13\">paralytic</span> ileus</li>\n<li>Produces foot drop</li>\n<li>Causes SIADH</li>\n<li>Causes glove and stocking neuropathy</li>\n</ul>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li>Highly neurotoxic</li>\n<li>Causes <span class=\"customMeta\" data-dictid=\"14bba9af561692777194c8cadacf13\">paralytic</span> ileus</li>\n<li>Causes glove and stocking neuropathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following purine analogues is considered the drug of choice (DOC) for treating hairy cell leukemia?", "options": [{"label": "A", "text": "Thioguanine", "correct": false}, {"label": "B", "text": "Cladribine", "correct": true}, {"label": "C", "text": "Fludarabine", "correct": false}, {"label": "D", "text": "Mercaptopurine", "correct": false}], "correct_answer": "B. Cladribine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:700px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Purine Analogue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cladribine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Hairy cell <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (DOC), multiple sclerosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fludarabine (Option C -Ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Chronic lymphocytic <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (CLL) [DOC], <span class=\"customMeta\" data-dictid=\"5297b5833216927771910b7a85de53\">low-grade</span> non-Hodgkin's lymphoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mercaptopurine (Option D -Ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Acute lymphoblastic <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (ALL) maintenance, <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> disease (off-label)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Thioguanine (Option A- Ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Acute <span class=\"customMeta\" data-dictid=\"da88d7f2211692777193037caba514\">myeloid</span> <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (AML)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pentostatin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Hairy cell leukemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Azathioprine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Organ transplantation, <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">rheumatoid</span> arthritis, <span class=\"customMeta\" data-dictid=\"5eddae989e1692777189a59921cc61\">IBD</span> (DOC) and <span class=\"customMeta\" data-dictid=\"d9bf27b09416927771984cdc6c0bc4\">SLE</span> (DOC)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nelarabine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">T-cell <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> lymphoblastic <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (T-ALL), T-cell lymphoblastic <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">lymphoma</span> (T-LBL) [DOC]</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clofarabine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Pediatric ALL (DOC)</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following conditions and the pyrimidine analogues which are used as drugs of choice. a) Pancreatic cancer 1. Cytosine arabinoside b) Acute Myeloid Leukemia (AML) 2. Azacitidine c) Myelodysplastic syndrome 3. 5-Fluorouracil d) Colorectal Cancer 4. Gemcitabine", "options": [{"label": "A", "text": "a) - 4; b) - 1; c) - 2; d) - 3", "correct": true}, {"label": "B", "text": "a) - 3; b) - 4; c) - 1; d) - 2", "correct": false}, {"label": "C", "text": "a) - 1; b) - 2; c) - 3; d) - 4", "correct": false}, {"label": "D", "text": "a) - 2; b) - 3; c) - 4; d) - 1", "correct": false}], "correct_answer": "A. a) - 4; b) - 1; c) - 2; d) - 3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pyrimidine Analogue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use(s)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-Fluorouracil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Colorectal cancer, breast cancer, other solid tumors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cytarabine (Cytosine arabinoside)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"da88d7f2211692777193037caba514\">myeloid</span> <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (AML), <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> lymphocytic <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">leukemia</span> (ALL), non-Hodgkin lymphoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gemcitabine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatic cancer (DOC), non-small cell lung cancer, <span class=\"customMeta\" data-dictid=\"e6cfda323816927771839cc83e376d\">bladder</span> cancer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Azacitidine and Decitabine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Myelodysplastic syndromes (DOC), AML</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Capecitabine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Colorectal cancer, breast cancer, <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> cancer</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman with metastatic breast cancer is undergoing chemotherapy. She presents with complaints of redness, swelling, and pain on her palms and soles. She describes a tingling sensation that has progressed to a burning pain over the past week. Upon physical examination, there is erythema and mild swelling of the affected areas, with some peeling of the skin as shown below. Her current chemotherapy regimen includes capecitabine and docetaxel. Which of the following is the most likely diagnosis for this patient's symptoms?", "options": [{"label": "A", "text": "Erythromelalgia", "correct": false}, {"label": "B", "text": "Erythema multiforme", "correct": false}, {"label": "C", "text": "Hand-foot syndrome (palmar-plantar erythrodysesthesia)", "correct": true}, {"label": "D", "text": "Stevens-Johnson syndrome", "correct": false}], "correct_answer": "C. Hand-foot syndrome (palmar-plantar erythrodysesthesia)", "question_images": ["https://image.prepladder.com/content/cjwK1R3Ta595fKThK6uO1736435316.png"], "explanation_images": ["https://image.prepladder.com/content/5aB667crEfDZ0EAw8K4u1728894972.png", "https://image.prepladder.com/content/u56uGnvuAbwqb9RRjQoF1728895006.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old patient with colorectal cancer is being treated with 5-fluorouracil (5-FU) as part of their chemotherapy regimen. Which of the following best describes the mechanism by which 5-fluorouracil exerts its anti-cancer effects in this patient?", "options": [{"label": "A", "text": "5-Fluorouracil inhibits DNA synthesis by incorporating into the DNA strand and causing chain termination.", "correct": false}, {"label": "B", "text": "5-Fluorouracil inhibits RNA polymerase, preventing the transcription of mRNA.", "correct": false}, {"label": "C", "text": "5-Fluorouracil is converted into fluorodeoxyuridine monophosphate (FdUMP), which inhibits thymidylate synthase, leading to decreased thymidine production and inhibition of DNA synthesis.", "correct": true}, {"label": "D", "text": "5-Fluorouracil activates topoisomerase I, causing breaks in DNA strands.", "correct": false}], "correct_answer": "C. 5-Fluorouracil is converted into fluorodeoxyuridine monophosphate (FdUMP), which inhibits thymidylate synthase, leading to decreased thymidine production and inhibition of DNA synthesis.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/V1rWUe2Fiiun2LJ5YDVn1736435246.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman with a history of rheumatoid arthritis under medication presents with complaints of fatigue, oral ulcers, and a non-productive cough. On examination, she appears pale, and reveals a temp of 100.9°F. Laboratory investigations show the following: Pancytopenia, elevated BUN and creatinine levels and elevated transaminases. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Systemic lupus erythematosus (SLE)", "correct": false}, {"label": "B", "text": "Methotrexate toxicity", "correct": true}, {"label": "C", "text": "Felty's syndrome", "correct": false}, {"label": "D", "text": "Acute viral hepatitis", "correct": false}], "correct_answer": "B. Methotrexate toxicity", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old female presents with vaginal bleeding, abdominal pain, and a high serum β-hCG level. Imaging studies and histopathology confirm a diagnosis of choriocarcinoma. The oncologist decides to start treatment with a chemotherapeutic agent. Which of the following drugs is most appropriate for this patient?", "options": [{"label": "A", "text": "Cisplatin", "correct": false}, {"label": "B", "text": "Methotrexate", "correct": true}, {"label": "C", "text": "Doxorubicin", "correct": false}, {"label": "D", "text": "Vincristine", "correct": false}], "correct_answer": "B. Methotrexate", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/tpke0XvUy2hgZ59Mgy5z1736435157.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65 y/o male is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma. During his treatment, he developed pancytopenia, characterized by anemia, leukopenia, and thrombocytopenia. The oncologist reviews the patient's medication list to determine which drug might be responsible for the patient’s lab results. All of the following drugs could be responsible for the patient’s condition except?", "options": [{"label": "A", "text": "Cyclophosphamide", "correct": false}, {"label": "B", "text": "Methotrexate", "correct": false}, {"label": "C", "text": "Doxorubicin", "correct": false}, {"label": "D", "text": "Vincristine", "correct": true}], "correct_answer": "D. Vincristine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qpickuKgDiNUq2HxNfb41736434661.png", "https://image.prepladder.com/content/jk4CqnECc7gLzhJpIpuH1736434691.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male presents with a history of recurrent episodes of severe pain in his limbs and chest, especially during cold weather or after vigorous physical activity. His medical history reveals multiple hospital admissions for similar episodes, diagnosed as vaso-occlusive crises. Laboratory investigations confirm the presence of hemoglobin S. His physician decides to start him on a medication that helps to reduce the frequency of painful crises and the need for blood transfusions. Which of the following is the most appropriate medication for this patient's condition?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Hydroxyurea", "correct": true}, {"label": "C", "text": "Imatinib", "correct": false}, {"label": "D", "text": "Anagrelide", "correct": false}], "correct_answer": "B. Hydroxyurea", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male patient is diagnosed with locally advanced squamous cell carcinoma of the head and neck. His oncologist recommends a combination of radiation therapy and chemotherapy. The patient expresses concern about the potential damage to his surrounding normal tissues from the radiation. To address his concerns, the oncologist considers using both a radio-sensitizer and a radio-protector.Which of the following combinations of agents is most appropriate for this patient's treatment plan?", "options": [{"label": "A", "text": "Cisplatin and amifostine", "correct": true}, {"label": "B", "text": "Doxorubicin and vitamin C", "correct": false}, {"label": "C", "text": "Metformin and hyperbaric oxygen", "correct": false}, {"label": "D", "text": "Gemcitabine and sodium selenite", "correct": false}], "correct_answer": "A. Cisplatin and amifostine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/zO2sQO7O5HrEWNcKdpyb1736434993.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/odexsfeXDEzlIbwI0bvR1747295952.mp3", "video": ""}, {"text": "A 55-year-old male patient, who has been diagnosed with metastatic testicular cancer, has been receiving cisplatin as part of his chemotherapy regimen. After his third cycle, he reports experiencing fatigue, decreased urine output, and mild swelling in his ankles. Blood tests reveal an elevated serum creatinine level and reduced glomerular filtration rate (GFR). Which of the following is the most appropriate management step?", "options": [{"label": "A", "text": "Increase the cisplatin dosage to overcome resistance.", "correct": false}, {"label": "B", "text": "Switch to another platinum-based drug such as carboplatin, which has a similar nephrotoxicity profile.", "correct": false}, {"label": "C", "text": "Administer i.v. hydration and consider using amifostine as a nephroprotective agent.", "correct": true}, {"label": "D", "text": "Discontinue all chemotherapy and initiate dialysis immediately.", "correct": false}], "correct_answer": "C. Administer i.v. hydration and consider using amifostine as a nephroprotective agent.", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "As a pharmaceutical researcher, you are tasked with summarizing the primary uses of platinum-based chemotherapy agents. Which of the following statements is incorrect with respect to uses of cisplatin and carboplatin?", "options": [{"label": "A", "text": "Carboplatin is used for the treatment of retinoblastoma along with bleomycin and vincristine.", "correct": true}, {"label": "B", "text": "Platinum compounds are used in bone tumors such as osteosarcoma.", "correct": false}, {"label": "C", "text": "Platinum compounds are combined with 5- fluorouracil &amp;amp; radiosensitizers for the treatment of gastrointestinal tract cancers and head &amp;amp; neck cancers.", "correct": false}, {"label": "D", "text": "Paclitaxel, when combined with cisplatin/carboplatin, produces complete resolution in the patients of ovarian cancer.", "correct": false}], "correct_answer": "A. Carboplatin is used for the treatment of retinoblastoma along with bleomycin and vincristine.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gastrointestinal <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">Tract</span> (GIT) Cancers:</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Esophagus, stomach, colorectal, anal cancers</li>\n<li>Combined with 5- <span class=\"customMeta\" data-dictid=\"041690b8f01692777203bc43957043\">fluorouracil</span> and radiosensitizers</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Head and Neck Cancers:</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Combined with 5- <span class=\"customMeta\" data-dictid=\"041690b8f01692777203bc43957043\">fluorouracil</span> and radiosensitizers</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Urogenital Cancers:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cervical Cancer</li>\n<li>Ovarian Cancer <strong>(Option D)</strong></li>\n<li>Testicular Cancer (<strong>BEP regimen</strong>: Bleomycin, Etoposide, Platin- Cisplatin/Carboplatin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Retinoblastoma:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>VEC regimen</strong> (Vincristine, Etoposide, Carboplatin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Other Uses:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osteosarcoma <strong>(Option B)</strong></li>\n<li>Lung Cancer</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following drugs with their primary uses: Drug Primary Use 1. Sargramostim A. Granulocyte- CSF used in Stem cell extraction 2. Melphalan B. Granulocyte- Macrophage CSF used in Stem cell extraction 3. Plerixafor C. Used in myeloablation for bone marrow transplantation 4. Filgrastim D. Blocks CXCR4 receptor for stem cell mobilization", "options": [{"label": "A", "text": "1-B, 2-C, 3-A, 4-D", "correct": false}, {"label": "B", "text": "1-B, 2-C, 3-D, 4-A", "correct": true}, {"label": "C", "text": "1-A, 2-D, 3-C, 4-B", "correct": false}, {"label": "D", "text": "1-A, 2-C, 3-D, 4-B", "correct": false}], "correct_answer": "B. 1-B, 2-C, 3-D, 4-A", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qM8wHJigCDl9RheLFC6T1736434948.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7tGGOwc5Shv8je75bwCy1746256623.mp3", "video": ""}, {"text": "Match the following cytotoxic drugs with their primary uses: Cytotoxic Drugs Primary Use 1. Temozolomide A. Treatment of Hodgkin's lymphoma 2. Dacarbazine B. DOC of glioma tumors 3. Trabectedin C. Organophosphate used in myeloablative procedures 4. Thiotepa D. Used in cisplatin-resistant ovarian cancer cases 5. Altretamine E. Treatment of leiomyosarcoma", "options": [{"label": "A", "text": "1-B, 2-A, 3-E, 4-C, 5-D", "correct": true}, {"label": "B", "text": "1-A, 2-B, 3-E, 4-D, 5-C", "correct": false}, {"label": "C", "text": "1-B, 2-E, 3-A, 4-D, 5-C", "correct": false}, {"label": "D", "text": "1-E, 2-C, 3-B, 4-A, 5-D", "correct": false}], "correct_answer": "A. 1-B, 2-A, 3-E, 4-C, 5-D", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/6i8MUjRbCuvjyJx564661736434874.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XNhMm1WCKtq1s8fTMhJs1745664299.mp3", "video": ""}, {"text": "A 60-year-old female with a history of chronic myeloid leukemia (CML) is being treated with Busulfan. She presents to the clinic with complaints of abdominal pain and swelling, fatigue, and yellowing of the skin. Additionally, the patient reports experiencing episodes of seizures since starting busulfan therapy. Upon examination, the patient has hepatomegaly and jaundice. Liver function tests indicate elevated liver enzymes. Which of the following statements is incorrect for the next steps?", "options": [{"label": "A", "text": "The patient’s should be started on defibrotide as the symptoms are likely due to Budd-Chiari syndrome (Veno-Occlusive Disease)", "correct": false}, {"label": "B", "text": "Prompt administration of warfarin to reduce chances of another episode of VOD.", "correct": true}, {"label": "C", "text": "Patients should be started on antiepileptics such as phenytoin to prevent seizures.", "correct": false}, {"label": "D", "text": "Adjust the dose of busulfan based on plasma drug-level monitoring.", "correct": false}], "correct_answer": "B. Prompt administration of warfarin to reduce chances of another episode of VOD.", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male with a history of non-Hodgkin's lymphoma is receiving chemotherapy, including cyclophosphamide. After a few weeks of treatment, he presents with symptoms of urinary frequency, urgency, and dysuria. Urinalysis reveals hematuria. The patient's physician suspects hemorrhagic cystitis. Which of the following statements is false regarding the use of cyclophosphamide?", "options": [{"label": "A", "text": "Hemorrhagic cystitis is primarily caused by the direct cytotoxic effect of cyclophosphamide on the bladder epithelium.", "correct": true}, {"label": "B", "text": "Ifosfamide, a modification of cyclophosphamide, is more likely to cause hemorrhagic cystitis than cyclophosphamide itself.", "correct": false}, {"label": "C", "text": "Cyclophosphamide is metabolized into 4-hydroxy cyclophosphamide in the liver by CYP2B6.", "correct": false}, {"label": "D", "text": "Hemorrhagic cystitis is treated by MESNA (Mercapto-Ethane-Sulfonate-Sodium,) which neutralizes toxic effects in the bladder.", "correct": false}], "correct_answer": "A. Hemorrhagic cystitis is primarily caused by the direct cytotoxic effect of cyclophosphamide on the bladder epithelium.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/VQov08nMM2s6Z2LY63gl1736434800.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65 y/o male presents with complaints of fatigue, lower back pain, and recurrent infections over the past few months. He also reports recent weight loss and increased thirst. O/E, pallor is noted. His lab investigations revealed anemia, hypercalcemia, elevated serum creatinine, hypoproteinemia, and M Spike in SPEP test. His urinalysis also showed Bence Jones proteins.Which of the following nitrogen mustard derivatives should be used in treating this patient?", "options": [{"label": "A", "text": "Cyclophosphamide", "correct": false}, {"label": "B", "text": "Mechlorethamine", "correct": false}, {"label": "C", "text": "Chlorambucil", "correct": false}, {"label": "D", "text": "Melphalan", "correct": true}], "correct_answer": "D. Melphalan", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:640px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nitrogen mustards</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Melphalan (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tx of Multiple Myeloma</li>\n<li>Myeloablative procedures</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechlorethamine </strong></p>\n<p style=\"text-align:center\"><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tx of Hodgkin's <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">lymphoma</span> ( <span class=\"customMeta\" data-dictid=\"284c5ef9ff1692777180e0bbd4dbb1\">ABVD</span> &amp; <span class=\"customMeta\" data-dictid=\"88a9a568931692777192009538aa79\">MOPP</span> Regimen)</li>\n<li>Tx of <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> T-cell lymphoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Cyclophosphamide </strong></p>\n<p style=\"text-align:center\"><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC in Burkitt’s lymphoma</li>\n<li>Tx of other cancers eg.\n\t\t\t\t<ul>\n<li>Breast cancer</li>\n<li>Ovarian cancer</li>\n<li>Neuroblastoma</li>\n<li>Non-Hodgkin's lymphoma</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Immunosuppressant in Wegener's <span class=\"customMeta\" data-dictid=\"2db4616dd0169277718891a2a1b67c\">Granulomatosis</span> (DOC)</li>\n<li>Acute cerebral vasculitis</li>\n<li>Rheumatoid arthritis</li>\n<li>Steroid dependent <span class=\"customMeta\" data-dictid=\"7063996c3816927771930f70c92eb4\">nephrotic</span> syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Chlorambucil </strong></p>\n<p style=\"text-align:center\"><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>2nd line Tx of CLL</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Busulfan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tx of <span class=\"customMeta\" data-dictid=\"32c39405871692777184d06d6c01ab\">CML</span> and <span class=\"customMeta\" data-dictid=\"9ab5f0308116927771814e1fcc72d6\">AML</span> in resistant cases</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55 y/o male presents with stage 3 lung cancer. The oncologist recommends treatment with a chemotherapy regimen that includes a cytotoxic drug known to be most effective during the S phase of the cell cycle. Which of the following cytotoxic drugs did he most likely recommend?", "options": [{"label": "A", "text": "Vincristine", "correct": false}, {"label": "B", "text": "Cisplatin", "correct": false}, {"label": "C", "text": "5- Fluorouracil", "correct": true}, {"label": "D", "text": "Bleomycin", "correct": false}], "correct_answer": "C. 5- Fluorouracil", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/6QFI00RnZckCE3YCFrAk1736434737.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50 y/o male was diagnosed with Hodgkin's lymphoma two years ago. He underwent chemotherapy for the same. Recently, the patient has presented with symptoms of fatigue, easy bruising, and recurrent infections. Laboratory tests and bone marrow biopsy confirmed a diagnosis of AML. Which of the following drugs used in the treatment of this patient's Hodgkin's lymphoma is most likely responsible for the development of his condition?", "options": [{"label": "A", "text": "Doxorubicin", "correct": false}, {"label": "B", "text": "Vincristine", "correct": false}, {"label": "C", "text": "Bleomycin", "correct": false}, {"label": "D", "text": "Procarbazine", "correct": true}], "correct_answer": "D. Procarbazine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Latency to t-AML/t-MDS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Leukemogenesis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alkylating agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Procarbazine, Cyclophosphamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2–10 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DNA <span class=\"customMeta\" data-dictid=\"2cf4952c63169277718543a0883583\">cross-linking</span> → chromosomal aberrations</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Topoisomerase II inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Etoposide, Doxorubicin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1–3 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MLL gene rearrangements</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antimetabolites</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6-Mercaptopurine, 5-FU</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> interference, less leukemogenic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radiation therapy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>–</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5–20 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DNA <span class=\"customMeta\" data-dictid=\"cf25c7ba04169277719946f465928b\">strand</span> breaks → chromosomal damage</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Secondary cancer</p>\n<p>(Most common = AML)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Procarbazine, Cisplatin, Etoposide, Mitoxantrone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All cytotoxic drugs except Vincristine, Asparaginase, Bleomycin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most Emetogenic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cisplatin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pulmonary fibrosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclophosphamide, Bleomycin, Carmustine, Methotrexate, Busulfan</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiotoxicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Daunorubicin &gt; Doxorubicin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hemorrhagic cystitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ifosfamide &gt; Cyclophosphamide</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45 y/o male with AML has been undergoing intensive chemotherapy. Three days after starting treatment, he developed a sudden onset of weakness, nausea, and muscle cramps. Laboratory tests reveal hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia. His urine output has decreased significantly over the past 24 hours. Which of the following is not a treatment option for this patient?", "options": [{"label": "A", "text": "Aggressive intravenous hydration", "correct": false}, {"label": "B", "text": "Allopurinol", "correct": false}, {"label": "C", "text": "Rasburicase", "correct": false}, {"label": "D", "text": "Sodium bicarbonate", "correct": true}], "correct_answer": "D. Sodium bicarbonate", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intrinsic tumor - related risk factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Patient - related risk factors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High risk cancers - Burkitt lymphoma, ALL and <span class=\"customMeta\" data-dictid=\"9ab5f0308116927771814e1fcc72d6\">AML</span> (with <span class=\"customMeta\" data-dictid=\"09be7d1f11169277720210bf5b0280\">WBC</span> &gt; 1 lakh), <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">Diffuse</span> large B cell lymphoma, etc.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pre-treatment <span class=\"customMeta\" data-dictid=\"e22be927921692777189c58bef4715\">Hyperuricemia</span> or Hyperphosphatemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"8eedb6cec61692777196a6a3b93d3f\">proliferation</span> Rate.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pre-existing <span class=\"customMeta\" data-dictid=\"b06dd1c5181692777193f14f3ed7d7\">nephropathy</span> / oliguria.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Large tumor burden (&gt; 10cm).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inadequate hydration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemosensitivity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 37 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which corticosteroid is recommended for promoting the maturation of fetal lungs in preterm labor?", "options": [{"label": "A", "text": "Hydrocortisone", "correct": false}, {"label": "B", "text": "Triamcinolone", "correct": false}, {"label": "C", "text": "Methylprednisolone", "correct": false}, {"label": "D", "text": "Betamethasone", "correct": true}], "correct_answer": "D. Betamethasone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D: Betameth\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please match the drugs with their respective targets of action. Trastuzumab BCR-ABL tyrosine kinase Infliximab 2. mTOR Sirolimus 3. TNF alpha Imatinib 4. HER2/neu", "options": [{"label": "A", "text": "A-2, B-3, C-1, D-4", "correct": false}, {"label": "B", "text": "A-4, B-3, C-1, D-2", "correct": false}, {"label": "C", "text": "A-3, B-4, C-2, D-1", "correct": false}, {"label": "D", "text": "A-4, B-3, C-2, D-1", "correct": true}], "correct_answer": "D. A-4, B-3, C-2, D-1", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs with their respective targets of action:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trastuzumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HER2/neu</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infliximab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>TNF alpha</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sirolimus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>mTOR</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Imatinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BCR-ABL tyrosine kinase</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>HER2/neu</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trastuzumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HER2-overexpressing breast and <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> cancer.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiotoxic, should be avoided with Doxorubicin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TNF alpha</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infliximab, Adalimumab, Certolizumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>used to treat <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> conditions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased risk of infections and cancer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>mTOR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sirolimus</strong>, Temsirolimus, Everolimus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Medicated stents, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Cell Carcinoma, Breast Cancer, Pancreatic <span class=\"customMeta\" data-dictid=\"7eca2476201692777193e0a0959bd7\">Neuroendocrine</span> Tumors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mouth sores, rash, diarrhea, infections, elevated cholesterol, liver <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> elevations, and lung issues.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BCR-ABL tyrosine kinase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Imatinib, Dasatinib, Nilotinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CML, <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">Gastrointestinal</span> Stromal Tumors (GIST)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generally well tolerated, some common side effects:</p>\n<ul>\n<li>Nausea and vomiting</li>\n<li>Fatigue and weakness</li>\n<li>Edema (swelling), particularly in the legs and ankles</li>\n<li>Muscle cramps and joint pain</li>\n<li>Rash and <span class=\"customMeta\" data-dictid=\"c238cff71916927771965fb88e6cc4\">pruritus</span> (itching)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient diagnosed with breast cancer, who is 53 years old and also has heart failure, which medication should be avoided?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Epirubicin", "correct": true}, {"label": "C", "text": "Cyclophosphamide", "correct": false}, {"label": "D", "text": "Cisplatin", "correct": false}], "correct_answer": "B. Epirubicin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Epiru\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Nivolumab is used as a checkpoint inhibitor in which of the following?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": false}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "Pleuropulmonaryblastoma", "correct": false}, {"label": "D", "text": "Hodgkin’s lymphoma", "correct": true}], "correct_answer": "D. Hodgkin’s lymphoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Hodgkin’s lymphoma</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nivolumab</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nivolumab is a <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> that targets the programmed <span class=\"customMeta\" data-dictid=\"2f3a62230316927771846649e8b780\">cell death</span> protein 1 (PD-1) <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> on T cells.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>PD-1 is a <span class=\"customMeta\" data-dictid=\"cd249aae061692777184c11176df48\">checkpoint</span> protein that is expressed on the surface of T cells</li>\n<li>It helps to regulate the <span class=\"customMeta\" data-dictid=\"dc6add5cf91692777189b30a6bae38\">immune response</span> by inhibiting T-cell <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> and proliferation.</li>\n<li>It has two ligands, PD-L1 and PD-L2, and when PD-1 binds to these ligands, it sends a signal to the T cell to \"turn off\" and stop attacking the cancer cell.</li>\n<li>By <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the PD-1 checkpoint, nivolumab enhances the anti-tumour activity of T cells and promotes an <span class=\"customMeta\" data-dictid=\"dc6add5cf91692777189b30a6bae38\">immune response</span> against cancer cells.</li>\n</ul>\n<p> </p>\n<ul>\n<li>It is different from traditional <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> and radiation therapy, and it is considered a type of <span class=\"customMeta\" data-dictid=\"2c003a40ea1692777189ec17568ab1\">immunotherapy</span> that harnesses the immune system to fight cancer.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Replasped classical Hodgkin’s lymphoma</li>\n<li>Advanced melanoma</li>\n<li>Advanced non-small cell lung cancer (that was previously treated)</li>\n<li>Renal cell carcinoma</li>\n<li>Head and neck cancer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rash</li>\n<li>Fatigue, muscle pain</li>\n<li>Reduced appetite</li>\n<li>Constipation</li>\n<li>Pneumonitis</li>\n<li>Colitis</li>\n<li>Nephritis</li>\n<li>Hepatitis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of Methotrexate in Osteosarcoma?", "options": [{"label": "A", "text": "Analogue of UMP", "correct": false}, {"label": "B", "text": "Competitive inhibitor of DHFR", "correct": true}, {"label": "C", "text": "Blocks Purine synthesis", "correct": false}, {"label": "D", "text": "Blocks Pyrimidine synthesis", "correct": false}], "correct_answer": "B. Competitive inhibitor of DHFR", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Q4IuhGRbm5wUBNnrzvG51746441435.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following interleukin (IL) is inhibited by Tocilizumab?", "options": [{"label": "A", "text": "IL-2", "correct": false}, {"label": "B", "text": "IL-5", "correct": false}, {"label": "C", "text": "IL-4", "correct": false}, {"label": "D", "text": "IL-6", "correct": true}], "correct_answer": "D. IL-6", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A boy presents with pallor and lymphadenopathy, and an X-ray of his skull is given below. Which of the following drugs is not used for the management of the suspected diagnosis?", "options": [{"label": "A", "text": "Cyclosporine", "correct": false}, {"label": "B", "text": "Methotrexate", "correct": false}, {"label": "C", "text": "Vinblastine", "correct": false}, {"label": "D", "text": "Vincristine", "correct": true}], "correct_answer": "D. Vincristine", "question_images": ["https://image.prepladder.com/content/VBNzLvCGBbueV0lWDnO41745822806.png"], "explanation_images": [], "explanation": "<p>Correct Answer D - V\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is an inhibitor of DNA synthesis?", "options": [{"label": "A", "text": "6-Mercaptopurine", "correct": true}, {"label": "B", "text": "Mitomycin", "correct": false}, {"label": "C", "text": "Actinomycin", "correct": false}, {"label": "D", "text": "Asparaginase", "correct": false}], "correct_answer": "A. 6-Mercaptopurine", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Qlh2oF6sqWnPpXhYPlB71746436156.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old man was treated for a high-grade soft-tissue sarcoma with radiotherapy. Since he was not responding, he was shifted to chemotherapy. After initiating chemotherapy, he developed erythematous rashes over the areas where radiotherapy was administered earlier.Which of the following drugs causes this condition?", "options": [{"label": "A", "text": "Vincristine", "correct": false}, {"label": "B", "text": "Doxorubicin", "correct": true}, {"label": "C", "text": "Cyclophosphamide", "correct": false}, {"label": "D", "text": "6-Mercaptopurine", "correct": false}], "correct_answer": "B. Doxorubicin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Doxorubicin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Doxorubicin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>This leads to DNA Intercalation, Topoisomerase II Inhibition, and <span class=\"customMeta\" data-dictid=\"9d5d6b68e616927772031cfb280823\">free radical</span> formation, causing DNA damage.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Soft tissue sarcoma</li>\n<li>Hodgkins and Non-Hodgkins Lymphoma</li>\n<li>Lung carcinoma</li>\n<li>Leukaemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Radiation recall dermatitis</li>\n<li>Alopecia</li>\n<li>Stomatitis</li>\n<li>Dilated cardiomyopathy</li>\n<li>Peripheral neuropathy</li>\n<li>Hypersensitivity reaction - <span class=\"customMeta\" data-dictid=\"dc75edd604169277719735ac5b4d5b\">Rash</span> and fever</li>\n<li>Hyperpigmentation of skin and nails</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not an alkylating agent?", "options": [{"label": "A", "text": "Melphalan", "correct": false}, {"label": "B", "text": "Cyclophosphamide", "correct": false}, {"label": "C", "text": "Busulfan", "correct": false}, {"label": "D", "text": "5-Fluorouracil", "correct": true}], "correct_answer": "D. 5-Fluorouracil", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Wf9xvSmwtGHBVT4TR6Tf1747029386.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>5-Fluorouracil </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"e34386023d169277720036d8bccc88\">thymidylate</span> <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> after conversion to FdUMP, leading to decreased <span class=\"customMeta\" data-dictid=\"e32083bfa81692777200f1407487aa\">thymidine</span> production and <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of DNA synthesis</p>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"554\" src=\"https://image.prepladder.com/content/Wf9xvSmwtGHBVT4TR6Tf1747029386.png\" width=\"771\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Colorectal cancer\n\t\t\t\t<ul>\n<li><strong>FOLFOX Regimen</strong>: Folinic acid , Fluorouracil (5-FU), Oxaliplatin</li>\n<li><strong>FOLFIRINOX Regimen</strong>: Folinic acid, Fluorouracil (5-FU), Irinotecan, Oxaliplatin</li>\n</ul>\n</li>\n<li>All GIT cancer, along with platin</li>\n<li>Breast cancer</li>\n<li>Topical application on skin: For treatment of\n\t\t\t\t<ul>\n<li>Mycosis Fungoides (Sezary Syndrome)</li>\n<li>Basal Cell Carcinoma</li>\n<li>Actinic Keratosis</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</li>\n<li>Mucositis</li>\n<li>Hand-foot syndrome (palmar-plantar erythrodysesthesia)</li>\n<li>Alopecia</li>\n<li>Rarely - <span class=\"customMeta\" data-dictid=\"5dc2899332169277718350ff2207b9\">cardiotoxicity</span> and neurotoxicity</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which monoclonal antibody is used in cancer treatment?", "options": [{"label": "A", "text": "Omalizumab", "correct": false}, {"label": "B", "text": "Denosumab", "correct": false}, {"label": "C", "text": "Rituximab", "correct": true}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "C. Rituximab", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rituximab</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A chimeric murine/human <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> IgG1 <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> targets the CD20 B-cell surface antigen.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Upon binding to CD20, it induces B-cell <span class=\"customMeta\" data-dictid=\"803b5ed1c8169277719190b446ac83\">lysis</span> through two main mechanisms:</p>\n<ul>\n<li><strong>Complement-Dependent Cytotoxicity (CDC) and </strong></li>\n<li><strong>Antibody-Dependent Cellular Cytotoxicity (ADCC).</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>CD-20 positive B-cell non-Hodgkin's lymphoma</li>\n<li>Chronic lymphocytic leukemia</li>\n<li>Rheumatoid arthritis</li>\n<li>Pemphigus vulavaris</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pharmacokinetics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Half-life of 22 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Infusion reaction - fever, <span class=\"customMeta\" data-dictid=\"dc75edd604169277719735ac5b4d5b\">rash</span> and joint pain</li>\n<li>Upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Steven johnson syndrome</li>\n<li>Thrombocytopenia</li>\n<li>HBV reactivation</li>\n<li>Tumor <span class=\"customMeta\" data-dictid=\"803b5ed1c8169277719190b446ac83\">lysis</span> syndrome</li>\n<li>Cytokine release syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Note </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pretreatment with antihistamines, antipyretics and glucocorticoids reduces the risk of <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which adverse effect of Bleomycin is exacerbated by radiation exposure?", "options": [{"label": "A", "text": "Pulmonary toxicity", "correct": true}, {"label": "B", "text": "Gastric toxicity", "correct": false}, {"label": "C", "text": "Neural toxicity", "correct": false}, {"label": "D", "text": "Hepatotoxicity", "correct": false}], "correct_answer": "A. Pulmonary toxicity", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KsoOUlfO9sXQuxpFedwl1741037206.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is basiliximab?", "options": [{"label": "A", "text": "IL-1 receptor antagonist", "correct": false}, {"label": "B", "text": "Anit-CD3 antibody", "correct": false}, {"label": "C", "text": "IL-2 receptor antagonist", "correct": true}, {"label": "D", "text": "TNF inhibitor", "correct": false}], "correct_answer": "C. IL-2 receptor antagonist", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug should not be administered to a pregnant woman?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Amoxicillin", "correct": false}, {"label": "C", "text": "Ceftriaxone", "correct": false}, {"label": "D", "text": "Streptomycin", "correct": true}], "correct_answer": "D. Streptomycin", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Drug</strong></p>\n</td>\n<td>\n<p><strong>Contraindication/Considerations during Pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Accutane (Isotretinoin)</p>\n</td>\n<td>\n<p>Known to cause severe birth defects and should be avoided</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>ACE inhibitors</p>\n</td>\n<td>They can cause serious <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> complications, including <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> dysplasia, oligohydramnios, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> hypoplasia, and even <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> death</td>\n</tr>\n<tr>\n<td>\n<p>Angiotensin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers (ARBs)</p>\n</td>\n<td>\n<p>S/E include <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> dysfunction, oligohydramnios, and skeletal abnormalities</p>\n<p>They are particularly risky during the second and third trimesters.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Warfarin</p>\n</td>\n<td>\n<p>Can cross the <span class=\"customMeta\" data-dictid=\"5276da31d11692777195f0e82f5e1d\">placenta</span> and cause <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and abnormalities</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Methotrexate</p>\n</td>\n<td>\n<p>Teratogenic and should be avoided</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tetracyclines</p>\n</td>\n<td>\n<p>Can affect <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> bone and <span class=\"customMeta\" data-dictid=\"17dfb015d2169277720023db8fe9e5\">teeth</span> development and should be avoided</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>NSAIDs</p>\n</td>\n<td>\n<p>May increase the risk of complications during pregnancy</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Paroxetine (SSRI)</p>\n</td>\n<td>\n<p>Increased risk of <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> heart defects</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Valproic acid</p>\n</td>\n<td>\n<p>Increased risk of birth defects, developmental delays, and more</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Thalidomide</p>\n</td>\n<td>\n<p>Known to cause severe birth defects and should be avoided</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of methyl dopa?", "options": [{"label": "A", "text": "Blockade of beta adrenergic receptors", "correct": false}, {"label": "B", "text": "Agonism of beta 2 receptors", "correct": false}, {"label": "C", "text": "Agonism of alpha 2 receptors", "correct": true}, {"label": "D", "text": "Blockade of alpha 2 receptors", "correct": false}], "correct_answer": "C. Agonism of alpha 2 receptors", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug can be administered in the next cycle of chemotherapy to prevent neutropenia in a patient who has received anti-cancer therapy?", "options": [{"label": "A", "text": "Filgrastim", "correct": true}, {"label": "B", "text": "Prednisolone", "correct": false}, {"label": "C", "text": "Vitamin B12", "correct": false}, {"label": "D", "text": "Folic acid", "correct": false}], "correct_answer": "A. Filgrastim", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Drug</strong></p>\n</td>\n<td>\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td>\n<p><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Filgrastim</p>\n</td>\n<td>\n<p>Stimulates <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production</p>\n</td>\n<td>\n<p>Granix, Neupogen</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Pegfilgrastim</p>\n</td>\n<td>\n<p>Long-acting <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of filgrastim</p>\n</td>\n<td>\n<p>Neulasta</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Sargramostim</p>\n</td>\n<td>\n<p>Stimulates <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production and other immune cells</p>\n</td>\n<td>\n<p>Leukine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lenograstim</p>\n</td>\n<td>\n<p>Stimulates <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production</p>\n</td>\n<td>\n<p>Granocyte, Myelostim</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tbo-filgrastim</p>\n</td>\n<td>\n<p>Stimulates <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production</p>\n</td>\n<td>\n<p>Granix</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications must only be dispensed with a prescription from a licensed medical practitioner?", "options": [{"label": "A", "text": "Schedule M drugs", "correct": false}, {"label": "B", "text": "Schedule H drugs", "correct": true}, {"label": "C", "text": "Schedule J Drugs", "correct": false}, {"label": "D", "text": "Schedule X drugs", "correct": false}], "correct_answer": "B. Schedule H drugs", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B. Schedule H drug\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug would you prioritize as the final treatment option for a patient who has developed glaucoma alongside diabetic macular edema?", "options": [{"label": "A", "text": "Beta blocker", "correct": false}, {"label": "B", "text": "Alpha-blockers", "correct": false}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Prostaglandin analogs", "correct": true}], "correct_answer": "D. Prostaglandin analogs", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An infant had a serum bilirubin level of 33 mg/dL. The mother might have taken which of the following drugs during the third trimester for this to occur?", "options": [{"label": "A", "text": "Ampicillin", "correct": false}, {"label": "B", "text": "Co-trimoxazole", "correct": false}, {"label": "C", "text": "Azithromycin", "correct": false}, {"label": "D", "text": "Chloramphenicol", "correct": true}], "correct_answer": "D. Chloramphenicol", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the term used to describe drugs that claim to contain a certain amount of a specific ingredient on their packaging, but actually have a lower amount in reality?", "options": [{"label": "A", "text": "Misbranded drug", "correct": true}, {"label": "B", "text": "Adulterated drugs", "correct": false}, {"label": "C", "text": "Spurious drugs", "correct": false}, {"label": "D", "text": "Counterfeit drugs", "correct": false}], "correct_answer": "A. Misbranded drug", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following teratogenic effects can be caused by the use of lithium during pregnancy?", "options": [{"label": "A", "text": "Cardiac defects", "correct": true}, {"label": "B", "text": "Facial defects", "correct": false}, {"label": "C", "text": "CNS defects", "correct": false}, {"label": "D", "text": "Urogenital defects", "correct": false}], "correct_answer": "A. Cardiac defects", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs used in the treatment of breast cancer is a PARP inhibitor?", "options": [{"label": "A", "text": "Rucaparib", "correct": true}, {"label": "B", "text": "Palbociclib", "correct": false}, {"label": "C", "text": "Vemurafenib", "correct": false}, {"label": "D", "text": "Gemcitabine", "correct": false}], "correct_answer": "A. Rucaparib", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Aprepitant, a drug used to prevent late-onset chemotherapy-induced nausea and vomiting, acts through which of the following mechanisms?", "options": [{"label": "A", "text": "NK-1 antagonist", "correct": true}, {"label": "B", "text": "NK-1 agonist", "correct": false}, {"label": "C", "text": "NK-3 antagonist", "correct": false}, {"label": "D", "text": "NK-2 antagonist", "correct": false}], "correct_answer": "A. NK-1 antagonist", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - NK-1 Antag\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs used in the treatment of Multiple Myeloma is associated with an increased risk of developing Herpes zoster infection?", "options": [{"label": "A", "text": "Bortezomib", "correct": true}, {"label": "B", "text": "Daratumumab", "correct": false}, {"label": "C", "text": "Lomitapide", "correct": false}, {"label": "D", "text": "Lenalidomide", "correct": false}], "correct_answer": "A. Bortezomib", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - B\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old patient undergoing treatment with Mycophenolate mofetil (MMF) presents with a serum calcium level of 13.5 mg/dL. He also has myasthenia gravis. What is the most likely cause of the hypercalcemia in this patient?", "options": [{"label": "A", "text": "Drug-induced hypercalcemia", "correct": false}, {"label": "B", "text": "Primary hyperparathyroidism", "correct": false}, {"label": "C", "text": "Small cell lung cancer", "correct": false}, {"label": "D", "text": "Thymoma", "correct": true}], "correct_answer": "D. Thymoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Th\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-cancer medications is used for the treatment of Gastrointestinal Stromal Tumors (GIST) and Chronic Myeloid Leukemia (CML)?", "options": [{"label": "A", "text": "Imatinib", "correct": true}, {"label": "B", "text": "Methotrexate", "correct": false}, {"label": "C", "text": "Doxorubicin", "correct": false}, {"label": "D", "text": "Cisplatin", "correct": false}], "correct_answer": "A. Imatinib", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CML</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>GIST</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Imatinib</li>\n<li>Ponatinib</li>\n<li>Nilotinib</li>\n<li>Dasatinib</li>\n<li>Bosutinib</li>\n<li>Omacetaxine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sunitinib</li>\n<li>Imatinib</li>\n<li>Regorafenib</li>\n<li>Repretinib</li>\n<li>Avapritinib</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following is an HER-1 inhibitor?", "options": [{"label": "A", "text": "Panitumumab", "correct": true}, {"label": "B", "text": "Crizotinib", "correct": false}, {"label": "C", "text": "Alectinib", "correct": false}, {"label": "D", "text": "Lorlatinib", "correct": false}], "correct_answer": "A. Panitumumab", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Panitumu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the primary mechanism of action of methotrexate?", "options": [{"label": "A", "text": "Inhibits DNA synthesis by blocking thymidylate synthase", "correct": false}, {"label": "B", "text": "Inhibits dihydrofolate reductase, leading to decreased DNA synthesis", "correct": true}, {"label": "C", "text": "Inhibits RNA synthesis by blocking RNA polymerase", "correct": false}, {"label": "D", "text": "Interferes with microtubule formation during cell division", "correct": false}], "correct_answer": "B. Inhibits dihydrofolate reductase, leading to decreased DNA synthesis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is true about the KEYNOTE 189 trial?", "options": [{"label": "A", "text": "Pembrolizumab plus chemotherapy used in NSCLC", "correct": true}, {"label": "B", "text": "Nivolumab plus chemotherapy used in NSCLC", "correct": false}, {"label": "C", "text": "Pembrolizumab is used in NSCLC", "correct": false}, {"label": "D", "text": "Nivolumab is used in NSCLC", "correct": false}], "correct_answer": "A. Pembrolizumab plus chemotherapy used in NSCLC", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"0908e877ee16927771952c22d908ab\"&gt;Pembrolizumab&lt;/span&gt; plus &lt;span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\"&gt;chemotherapy&lt;/span&gt; used in NSCLC\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient undergoing chemotherapy was given an antiemetic, after which he developed symptoms like acute dystonia, bradykinesia, and tremors . Which of the following drugs would have caused these symptoms?", "options": [{"label": "A", "text": "Ondansetron", "correct": false}, {"label": "B", "text": "Metoclopramide", "correct": true}, {"label": "C", "text": "Meclizine", "correct": false}, {"label": "D", "text": "Scopolamine", "correct": false}], "correct_answer": "B. Metoclopramide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - M\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the key difference between Cisplatin and Carboplatin?", "options": [{"label": "A", "text": "Cisplatin is less neurotoxic than Carboplatin", "correct": false}, {"label": "B", "text": "Cisplatin causes fewer gastric issues compared to Carboplatin", "correct": false}, {"label": "C", "text": "Carboplatin is more neurotoxic than Cisplatin", "correct": false}, {"label": "D", "text": "Cisplatin has more nephrotoxic side effects compared to Carboplatin", "correct": true}], "correct_answer": "D. Cisplatin has more nephrotoxic side effects compared to Carboplatin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the most common side effect induced by cisplatin chemotherapy?", "options": [{"label": "A", "text": "GI symptoms", "correct": true}, {"label": "B", "text": "Neuropathy", "correct": false}, {"label": "C", "text": "Cardiotoxicity", "correct": false}, {"label": "D", "text": "Myopathy", "correct": false}], "correct_answer": "A. GI symptoms", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - GI\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In Carcinoma cervix, which chemotherapeutic agent is used?", "options": [{"label": "A", "text": "Paclitaxel", "correct": false}, {"label": "B", "text": "Cyclophosphamide", "correct": false}, {"label": "C", "text": "Cisplatin", "correct": true}, {"label": "D", "text": "Topotecan", "correct": false}], "correct_answer": "C. Cisplatin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications limit the accessibility of thymidylate?", "options": [{"label": "A", "text": "Rituximab", "correct": false}, {"label": "B", "text": "Cisplatin", "correct": false}, {"label": "C", "text": "5-fluorouracil", "correct": true}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "C. 5-fluorouracil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - 5-fluorou\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which chemotherapeutic medication may lead to renal tubular damage in a patient?", "options": [{"label": "A", "text": "Cisplatin", "correct": true}, {"label": "B", "text": "Streptozocin", "correct": false}, {"label": "C", "text": "Methysergide", "correct": false}, {"label": "D", "text": "Cyclophosphamide", "correct": false}], "correct_answer": "A. Cisplatin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Osimertinib is used in NSCLC with mutation due to:", "options": [{"label": "A", "text": "ROS1 mutation", "correct": false}, {"label": "B", "text": "T890M mutation", "correct": false}, {"label": "C", "text": "T790M mutation", "correct": true}, {"label": "D", "text": "M790T mutation", "correct": false}], "correct_answer": "C. T790M mutation", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the treatment for HER-2-positive trastuzumab-resistant breast cancer?", "options": [{"label": "A", "text": "Lapatinib", "correct": true}, {"label": "B", "text": "Sorafenib", "correct": false}, {"label": "C", "text": "Vemurafenib", "correct": false}, {"label": "D", "text": "Erlotinib", "correct": false}], "correct_answer": "A. Lapatinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mutation Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Generation/Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>HER1 (EGFR) - Non-Small Cell Lung Cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Erlotinib</strong>, Gefitinib</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1st Generation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Given in EGFR (+)ve lung cancer, pancreatic cancer.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Afatinib, Dacomitinib</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2nd Generation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Given in resistance of Erlotinib &amp; Gefitinib.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Osimertinib</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3rd Generation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Given in resistant cases of <span class=\"customMeta\" data-dictid=\"f303712d5a1692777180c8c49bdd95\">Afatinib</span> &amp; Dacomitinib.</p>\n<p>Given in T790M <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in EGFR receptor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mobocertinib</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>4th Generation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Given in resistant cases of Osimertinib.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cetuximab, Panitumumab, Necitumumab</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>MAB Approved</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks EGFR.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>HER2+ve - Breast Cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lapatinib</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Given in Trastuzumab-resistant cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neratinib, Tucatinib</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used in HER2 (+)ve breast cancer.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the most common side effect induced by cisplatin chemotherapy?", "options": [{"label": "A", "text": "GI symptoms", "correct": true}, {"label": "B", "text": "Neuropathy", "correct": false}, {"label": "C", "text": "Cardiotoxicity", "correct": false}, {"label": "D", "text": "Myopathy", "correct": false}], "correct_answer": "A. GI symptoms", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DhyV4cugT185VUZ7gUAR1747394703.png"], "explanation": "<p>Correct Answer A - GI\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs are used to treat chemotherapy-induced nausea and vomiting?", "options": [{"label": "A", "text": "Doxylamine + domperidone + aprepitant", "correct": false}, {"label": "B", "text": "Prochlorperazine + metoclopramide + domperidone", "correct": false}, {"label": "C", "text": "Dexamethasone + metoclopramide + domperidone", "correct": false}, {"label": "D", "text": "Granisteron + dexamethasone + aprepitant", "correct": true}], "correct_answer": "D. Granisteron + dexamethasone + aprepitant", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Granisteron + &lt;span class=\"customMeta\" data-dictid=\"1b969bdd951692777186a2a131511d\"&gt;dexamethasone&lt;/span&gt; + aprepitant</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Granisetron or Ondansetron</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>They are <strong>5-HT3 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong>, which blocks receptors in the gut and brain stimulated by <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> released during chemotherapy, reducing <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and preventing vomiting.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dexamethasone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"a3e96d80e9169277718551158bbcd4\">corticosteroid</span> with anti-inflammatory and <span class=\"customMeta\" data-dictid=\"c3c986cd721692777189b473814b2e\">immunosuppressive</span> effects, it reduces <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and suppresses the release of chemicals in the brain that trigger <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aprepitant</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is a <strong>substance P/neurokinin 1 (NK1) <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong> that works by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> NK1 receptors, inhibiting the action of <span class=\"customMeta\" data-dictid=\"b5b6dd01d6169277719947def8d8d3\">substance P</span> (a <span class=\"customMeta\" data-dictid=\"e28fd027b416927771932bc23ba0a5\">neurotransmitter</span> involved in triggering <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting).</p>\n<p>This medication is often used in combination with others as it targets different pathways in the development of chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), offering a more comprehensive approach to prevention and management. This combination therapy is particularly effective in preventing both <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> and delayed CINV.</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Antiemetic agents</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Class &amp; Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>5-HT<sub>3</sub> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</strong></p>\n<ul>\n<li>Ondansetron</li>\n<li>Palonosetron</li>\n<li>Granisetron</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting\n\t\t\t\t<ul>\n<li>Early onset: Ondansetron</li>\n<li>Late onset: Palonosetron</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Headache</li>\n<li><strong>QT prolongation</strong>\n<ul>\n<li>Maximum: <strong>Dolasetron</strong></li>\n<li>Minimum: <strong>Palonosetron</strong></li>\n</ul>\n</li>\n<li>Hypotension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Centrally acting D2 antagonists</strong></p>\n<ul>\n<li>Metoclopramide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n<li>Gastroparesis.</li>\n<li>Paralytic ileus.</li>\n<li>Bowel cleansing.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Extra-pyramidal symptoms (acute dystonia).</li>\n<li>Severe hyperprolactinemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Domperidone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild-moderate vomiting.</li>\n<li>GERD.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Minor EPS features.</li>\n<li>Mild hyperprolactinema.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Neurokinin-1 inhibitors</strong></p>\n<ul>\n<li>Aprepitant</li>\n<li>Fosaprepitant</li>\n<li>Rolapitant</li>\n<li>Netupitant</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Late-onset <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (DOC)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rolapitant:\n\t\t\t\t<ul>\n<li>Neutropenia.</li>\n<li>Hiccups.</li>\n<li>Decreased appetite.</li>\n<li>Dizziness.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cannabinoids</strong></p>\n<ul>\n<li>Dronabinol.</li>\n<li>Nabilone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n<li>Appetite <span class=\"customMeta\" data-dictid=\"bec9bb02501692777199b0f75e340e\">stimulant</span> (can be used in <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> and <span class=\"customMeta\" data-dictid=\"8deb4a7e2b1692777181c91be40ed9\">anorexia</span> patients.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypotension.</li>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> (bloodshot eyes)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Antihistamines</strong></p>\n<ul>\n<li>Cyclizine</li>\n<li>Meclizine.</li>\n<li>Promethazine.</li>\n<li>Diphenhydramine.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Motion sickness</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Sedation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Doxylamine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Morning <span class=\"customMeta\" data-dictid=\"73c1caf8d11692777198b1248373d3\">sickness</span> (given with pyridoxine)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dry mouth</li>\n<li>Drowsiness</li>\n<li>Dry mouth</li>\n<li>Constipation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Muscarinic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</strong></p>\n<ul>\n<li>Hyoscine (scopolamine)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Motion <span class=\"customMeta\" data-dictid=\"73c1caf8d11692777198b1248373d3\">sickness</span> (drug of choice, available as a <span class=\"customMeta\" data-dictid=\"48982b740216927772004a198271cd\">transdermal</span> patch)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dry mouth.</li>\n<li>Visual disturbances.</li>\n<li>Drowsiness.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The active metabolite of cyclophosphamide is :", "options": [{"label": "A", "text": "Aldophosphamide", "correct": false}, {"label": "B", "text": "4- hydroxy cyclophosphamide", "correct": true}, {"label": "C", "text": "4-Ketocyclophosphamide", "correct": false}, {"label": "D", "text": "Carboxyphosphamide", "correct": false}], "correct_answer": "B. 4- hydroxy cyclophosphamide", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/MrvKPKLFSQUSbwXuPdPS1745386579.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following drugs is the new FDA-approved immune checkpoint inhibitor for carcinoma endometrium?", "options": [{"label": "A", "text": "Nivolumab", "correct": false}, {"label": "B", "text": "Pembrolizumab", "correct": true}, {"label": "C", "text": "Ipilimumab", "correct": false}, {"label": "D", "text": "Trastuzumab", "correct": false}], "correct_answer": "B. Pembrolizumab", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uyjNQ4zrrdWM9iKYnOA11745385869.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The Nobel Prize in Physiology or Medicine , 2018 was awarded to James P. Allison and Tasuku Honjo for which of the following discoveries?", "options": [{"label": "A", "text": "Discovery of mechanisms of autophagy", "correct": false}, {"label": "B", "text": "Discoveries of molecular mechanisms controlling the circadian rhythm", "correct": false}, {"label": "C", "text": "Discovery of cancer therapy by inhibition of negative immune regulation", "correct": true}, {"label": "D", "text": "The discovery that matures cells can be reprogrammed to become pluripotent", "correct": false}], "correct_answer": "C. Discovery of cancer therapy by inhibition of negative immune regulation", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Discovery of cancer therapy by &lt;span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\"&gt;inhibition&lt;/span&gt; of negative immune regu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs causes flagellate pigmentation ?", "options": [{"label": "A", "text": "Bleomycin", "correct": true}, {"label": "B", "text": "Doxorubicin", "correct": false}, {"label": "C", "text": "Vincristine", "correct": false}, {"label": "D", "text": "Minocycline", "correct": false}], "correct_answer": "A. Bleomycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - B\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is the anticoagulant of choice for the management of cancer–associated thromboembolism ?", "options": [{"label": "A", "text": "Unfractionated Heparin", "correct": false}, {"label": "B", "text": "Warfarin", "correct": false}, {"label": "C", "text": "Low molecular weight heparin", "correct": true}, {"label": "D", "text": "Dabigatran", "correct": false}], "correct_answer": "C. Low molecular weight heparin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Low &lt;span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\"&gt;molecular weight&lt;/span&gt; h\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-CD 20 monoclonal antibodies is used in cancer therapy?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Rituximab", "correct": true}, {"label": "C", "text": "Cisplatin", "correct": false}, {"label": "D", "text": "5-Fluorouracil", "correct": false}], "correct_answer": "B. Rituximab", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Ritu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Monoclonal antibody used in cancer ?", "options": [{"label": "A", "text": "Rituximab", "correct": true}, {"label": "B", "text": "Cisplatin", "correct": false}, {"label": "C", "text": "5-Fluorouracil", "correct": false}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "A. Rituximab", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ritu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is most cardiotoxic anticancer drug ?", "options": [{"label": "A", "text": "Anthracyclines", "correct": true}, {"label": "B", "text": "Cyclophosphamide", "correct": false}, {"label": "C", "text": "Tamoxifen", "correct": false}, {"label": "D", "text": "Imatinib", "correct": false}], "correct_answer": "A. Anthracyclines", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Anth\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is associated with untoward side effects of renal tubular damage ?", "options": [{"label": "A", "text": "Cisplatin", "correct": true}, {"label": "B", "text": "Streptozocin", "correct": false}, {"label": "C", "text": "Methysergide", "correct": false}, {"label": "D", "text": "Cyclophosphamide", "correct": false}], "correct_answer": "A. Cisplatin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Class of Drug</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alkylating Agents</p>\n</td>\n<td>\n<p>Cyclophosphamide, Ifosfamide, Carmustine, Lomustine</p>\n</td>\n<td>\n<p>Nausea, vomiting, diarrhea, myelosuppression, infertility, hemorrhagic cystitis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antimetabolites</p>\n</td>\n<td>\n<p>Methotrexate, Fluorouracil, Capecitabine, Gemcitabine</p>\n</td>\n<td>\n<p>Nausea, vomiting, diarrhea, myelosuppression, mucositis, alopecia, hand-foot syndrome</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antitumor Antibiotics</p>\n</td>\n<td>\n<p>Doxorubicin, Daunorubicin, Epirubicin</p>\n</td>\n<td>\n<p>Cardiotoxicity, myelosuppression, mucositis, alopecia, hand-foot syndrome</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Microtubule Inhibitors</p>\n</td>\n<td>\n<p>Vinblastine, Vincristine, Paclitaxel, Docetaxel</p>\n</td>\n<td>\n<p>Peripheral neuropathy, myelosuppression, alopecia, mucositis, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Platinum Compounds</p>\n</td>\n<td>\n<p>Cisplatin, Carboplatin, Oxaliplatin</p>\n</td>\n<td>\n<p>Nephrotoxicity, ototoxicity, neuropathy, myelosuppression, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Topoisomerase Inhibitors</p>\n</td>\n<td>\n<p>Irinotecan, Topotecan, Etoposide, Teniposide</p>\n</td>\n<td>\n<p>Diarrhea, myelosuppression, mucositis, alopecia, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 58 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45 y/o male presents with fatigue, unintentional weight loss, and left upper quadrant abdominal discomfort. Physical examination shows splenomegaly. Lab tests show leukocytosis. The peripheral blood smear shows increased basophils, myelocytes, and segmented neutrophils. Bone marrow biopsy confirms hypercellularity with increased myeloid precursors and the presence of the Philadelphia chromosome (BCR-ABL fusion gene). Which of the following drugs would be your DOC to treat the patient?", "options": [{"label": "A", "text": "Ponatinib", "correct": false}, {"label": "B", "text": "Imatinib", "correct": true}, {"label": "C", "text": "Nilotinib", "correct": false}, {"label": "D", "text": "Dasatinib", "correct": false}], "correct_answer": "B. Imatinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:498px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st Generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Erlotinib</li>\n<li>Gefitinib</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2nd Generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Afatinib</li>\n<li>Dacomitinib</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3rd Generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osimertinib</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4th Generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mobocertinib</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old female patient diagnosed with a gastrointestinal stromal tumor (GIST) has been started on first-line treatment. Genetic testing reveals a mutation in the c-KIT gene. After several months, the patient develops resistance to the initial therapy. The oncologist considers alternative medications. Which of the following drugs is specifically known for selectively inhibiting the Platelet-Derived Growth Factor Receptor (PDGFR) rather than multiple tyrosine kinase receptors?", "options": [{"label": "A", "text": "Imatinib", "correct": false}, {"label": "B", "text": "Sunitinib", "correct": false}, {"label": "C", "text": "Ripretinib", "correct": true}, {"label": "D", "text": "Regorafenib", "correct": false}], "correct_answer": "C. Ripretinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Targets</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Line of Therapy in GIST</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imatinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>c-KIT, PDGFRα</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First-line</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sunitinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple TKs: KIT, PDGFR, VEGFR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second-line</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Regorafenib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multikinase: KIT, PDGFR, VEGFR, RAF, etc.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third-line</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ripretinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Broad-spectrum KIT and PDGFRα <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> (switch-control)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fourth-line or resistant cases</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is not commonly treated with Bruton’s Tyrosine Kinase (BTK) inhibitors?", "options": [{"label": "A", "text": "Mantle Cell Lymphoma", "correct": false}, {"label": "B", "text": "Marginal Zone Lymphoma", "correct": false}, {"label": "C", "text": "Chronic Lymphocytic Leukemia", "correct": false}, {"label": "D", "text": "Hodgkin's Lymphoma", "correct": true}], "correct_answer": "D. Hodgkin's Lymphoma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BTK <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">Inhibitor</span> Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Comments</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mantle Cell Lymphoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yes</strong> (e.g., Ibrutinib)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Approved indication</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marginal Zone Lymphoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yes</strong> (e.g., Zanubrutinib)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used especially in relapsed/refractory settings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic Lymphocytic Leukemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yes</strong> (Ibrutinib, Acalabrutinib)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First-line and relapsed settings</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hodgkin's Lymphoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not a BTK-driven disease; treated with chemotherapy/immunotherapy</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following drugs to their appropriate mutation targets in cancer treatment: 1. Erlotinib A. HER2 (+)ve Breast Cancer 2. Osimertinib B. HER1 (EGFR) mutation in Non-Small Cell Lung Cancer 3. Lapatinib C. T790M mutation in EGFR receptor 4. Neratinib D. Trastuzumab resistant HER2 (+)ve Breast Cancer", "options": [{"label": "A", "text": "1-C, 2-B, 3-D, 4-A", "correct": false}, {"label": "B", "text": "1-B, 2-C, 3-A, 4-D", "correct": false}, {"label": "C", "text": "1-C, 2-B, 3-A, 4-D", "correct": false}, {"label": "D", "text": "1-B, 2-C, 3-D, 4-A", "correct": true}], "correct_answer": "D. 1-B, 2-C, 3-D, 4-A", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Matched Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism &amp; Clinical Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Erlotinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B. HER1 (EGFR) <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in NSCLC</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reversible tyrosine <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (TKI) of <strong>EGFR (HER1)</strong>; used in <strong>EGFR-mutant NSCLC</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osimertinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C. T790M EGFR mutation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3rd-generation <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> EGFR-TKI that targets <strong>T790M</strong>, a common resistance mutation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lapatinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A. HER2 (+)ve Breast Cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dual <strong>HER2 and EGFR</strong> TKI used for <strong>HER2-positive breast cancer</strong>, usually after trastuzumab.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neratinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>D. Trastuzumab-resistant HER2+ Cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irreversible pan-HER <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <strong>HER1, HER2, and HER4</strong>, effective after <span class=\"customMeta\" data-dictid=\"3c1f84a831169277720091463322a7\">trastuzumab</span> failure.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Mutation/Context</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Targeted Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>EGFR (HER1)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NSCLC with EGFR mutations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erlotinib, Gefitinib, Afatinib</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T790M mutation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Resistance <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in EGFR+ NSCLC</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osimertinib</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>HER2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HER2-positive breast cancer</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trastuzumab, Pertuzumab, Lapatinib, Neratinib</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trastuzumab-resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HER2+ breast cancer non-responsive to trastuzumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neratinib, Tucatinib</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/luCUITBGFj6QRRmxOs2S1746256860.mp3", "video": ""}, {"text": "Match the drugs &amp;amp; their clinical use: Drug Clinical Use 1. Pazopanib A. Cholangiocarcinoma 2. Midostaurin B. Urothelial Carcinoma 3. Erdafitinib C. Acute Myeloid Leukemia (AML) with FLT-3 mutation 4. Infigratinib D. Renal Cell Carcinoma (RCC)", "options": [{"label": "A", "text": "1-D, 2-C, 3-B, 4-A", "correct": true}, {"label": "B", "text": "1-D, 2-C, 3-A, 4-B", "correct": false}, {"label": "C", "text": "1-C, 2-D, 3-A, 4-B", "correct": false}, {"label": "D", "text": "1-C, 2-D, 3-B, 4-A", "correct": false}], "correct_answer": "A. 1-D, 2-C, 3-B, 4-A", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"width:624px\">\n<tbody>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Clinical Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Pazopanib, Axitinib, Tivozanib</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Renal Cell <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> (RCC)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Sorafenib, Lenvatinib</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Renal Cell <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> (RCC), <span class=\"customMeta\" data-dictid=\"6165f47a8c1692777188c0dfc0d75d\">Hepatocellular</span> <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> (HCC)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Sunitinib, Regorafenib</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Renal Cell <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> (RCC), <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">Gastrointestinal</span> Stromal Tumors (GIST)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Vandetanib, Cabozantinib</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Medullary <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">Carcinoma</span> of the Thyroid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Midostaurin, Gilteritinib</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"da88d7f2211692777193037caba514\">Myeloid</span> <span class=\"customMeta\" data-dictid=\"4521dbf4b91692777191a73002bf98\">Leukemia</span> (AML) with FLT-3 mutation</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erdafitinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Urothelial Carcinoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pemigatinib, Infigratinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cholangiocarcinoma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old male patient diagnosed with malignant melanoma has not responded to initial therapies. His oncologist is considering targeted therapy options. Which of the following inhibitors can be used in malignant melanoma?", "options": [{"label": "A", "text": "Sirolimus", "correct": false}, {"label": "B", "text": "Binimetinib", "correct": true}, {"label": "C", "text": "Idelalisib", "correct": false}, {"label": "D", "text": "Adagrasib", "correct": false}], "correct_answer": "B. Binimetinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Inhibitor Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>RAS Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Sotorasib, <strong>Adagrasib</strong> <strong>(Option D Ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>NSCLC with KRAS mutation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>B-RAF Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Vemurafenib, Dabrafenib, Encorafenib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Malignant <span class=\"customMeta\" data-dictid=\"e42297345d16927771922d2d0dc020\">Melanoma</span> with B-RAF mutation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>MEK Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Trametinib, Cobimetinib, <strong>Binimetinib (Option B)</strong>, Selumetinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Malignant Melanoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>PI3K Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Idelalisib</strong> <strong>(Option C Ruled out)</strong>, Copanlisib, Duvelisib, Umbralisib, Alpelisib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>B Cell <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">Lymphoma</span> (CLL, SLL, FL)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>mTOR Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Sirolimus (Option A Ruled out)</strong>, Temsirolimus, Everolimus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>RCC (Renal Cell Carcinoma), Breast Cancer, <span class=\"customMeta\" data-dictid=\"cde2dcfb251692777195bb7a41d550\">PNET</span> (Pancreatic <span class=\"customMeta\" data-dictid=\"7eca2476201692777193e0a0959bd7\">Neuroendocrine</span> Tumors)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 52-year-old female presents with a diagnosis of invasive ductal carcinoma of the breast. The tumour measures 3 cm in diameter and has been staged as T2N1M0. Immunohistochemical testing reveals that the cancer cells overexpress the HER2 protein and are ER-negative. The patient has no significant comorbidities and has been scheduled for surgery. Which of the following drugs is most suitable for this patient as part of her adjuvant chemotherapy regimen", "options": [{"label": "A", "text": "Tamoxifen", "correct": false}, {"label": "B", "text": "Cetuximab", "correct": false}, {"label": "C", "text": "Trastuzumab", "correct": true}, {"label": "D", "text": "Bevacizumab", "correct": false}], "correct_answer": "C. Trastuzumab", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KI5ffGfpZT4iiU50IllV1736435764.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with a significant smoking history presents with a persistent cough, dyspnea, weight loss, and fatigue. A Chest CT reveals a suspicious mass in the right upper lobe. A biopsy of the mass shows adenocarcinoma. Further molecular testing reveals high PD-L1 expression (&amp;gt;50%) and no actionable mutations in EGFR, ALK, or ROS1. Which of the following drugs would you choose as the first line of treatment in this case?", "options": [{"label": "A", "text": "Erlotinib", "correct": false}, {"label": "B", "text": "Bevacizumab", "correct": false}, {"label": "C", "text": "Pembrolizumab", "correct": true}, {"label": "D", "text": "Ipilimumab", "correct": false}], "correct_answer": "C. Pembrolizumab", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/lWKK6hhPg6yCL2JANa4U1736435838.png", "https://image.prepladder.com/content/T9qsYnDojI7vWUDTbesP1736435889.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Blocks CTLA4 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Blocks PD-L-1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Blocks PD-1 receptor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ipilimumab</li>\n<li>Tremelimumab</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atezolizumab</li>\n<li>Avelumab</li>\n<li>Durvalumab</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nivolumab</li>\n<li>Cepilimumab</li>\n<li>Pembrolizumab</li>\n</ul>\n<p> </p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old man presents to the dermatology clinic with chronic, thick, silvery-white, scaly plaques on his elbows, knees, and lower back. He reports that the plaques have been present for several years and have gradually worsened. He has tried various OTC creams with minimal relief. The plaques are extensive on examination, and the patient rates his itching and discomfort as moderate to severe. Which of the following drugs is NOT relevant for this patient’s treatment?", "options": [{"label": "A", "text": "Ixekizumab", "correct": false}, {"label": "B", "text": "Secukinumab", "correct": false}, {"label": "C", "text": "Etanercept", "correct": false}, {"label": "D", "text": "Mogamulizumab", "correct": true}], "correct_answer": "D. Mogamulizumab", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UxLbMXCiokQFduwWthCp1736435945.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with hypertension and CKD presents with gross hematuria and flank pain. Imaging studies reveal a 7 cm mass in the left kidney concerning renal cell carcinoma. He undergoes a radical nephrectomy with pathological confirmation of clear cell RCC, pT3aN0M0 (stage III). Due to his advanced stage, you are considering adjuvant therapy with Aldesleukin. Which of the following is a potential mechanism of action of aldesleukin in treating RCC?", "options": [{"label": "A", "text": "Induction of angiogenesis", "correct": false}, {"label": "B", "text": "Activation of T cells", "correct": true}, {"label": "C", "text": "Inhibition of vascular endothelial growth factor (VEGF)", "correct": false}, {"label": "D", "text": "Direct cytotoxicity against tumor cells", "correct": false}], "correct_answer": "B. Activation of T cells", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with refractory multiple myeloma has undergone multiple lines of treatment including proteasome inhibitors, immunomodulatory drugs, and autologous stem cell transplantation. Despite these treatments, his disease has progressed. His oncologist decided to start him on a novel therapy that targets B-cell maturation antigen (BCMA) and delivers a cytotoxic agent to myeloma cells. Which drug is the patient likely being prescribed?", "options": [{"label": "A", "text": "Daratumumab", "correct": false}, {"label": "B", "text": "Elotuzumab", "correct": false}, {"label": "C", "text": "Belantamab Vedotin", "correct": true}, {"label": "D", "text": "Ixekizumab", "correct": false}], "correct_answer": "C. Belantamab Vedotin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Approved for</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gemtuzumab Ozogamicin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· CD33 + Calicheamicin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Relapsed AML</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Brentuximab Vedontin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· CD30 + Vedontin</p>\n<p>(microtubule cleaver)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· Hodgkin's <span class=\"customMeta\" data-dictid=\"5a31d184f21692777191a2e457d646\">lymphoma</span> (refractory)</p>\n<p>· Large B-cell lymphoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Belantamab Vedontin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· BCMA+ Vedontin</p>\n<p>(microtubule cleaver)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">Refractory</span> multiple myeloma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Polatuzumab Vedontin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· CD19 + Vedontin</p>\n<p>(microtubule cleaver)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· Relapsed AML</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moxetumomab Pasudotox</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· CD22 + <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">Linked</span> to <span class=\"customMeta\" data-dictid=\"dea08f9dd81692777196a5f62e6862\">pseudomonas</span> <span class=\"customMeta\" data-dictid=\"41329dc9381692777200a9b6d57cf4\">toxin</span> A</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>· <span class=\"customMeta\" data-dictid=\"a4789768d21692777188e77f1969cd\">Hairy</span> cell leukemia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old female with metastatic melanoma has experienced disease progression after treatment with a BRAF inhibitor and an immune checkpoint inhibitor targeting CTLA-4. Her oncologist now recommends a monoclonal antibody Pembrolizumab, that targets the PD-1 receptor to help reinvigorate T-cell activity against the tumor. Pembrolizumab can be used in the treatment of all of the following, except?", "options": [{"label": "A", "text": "Non-small cell lung cancer", "correct": false}, {"label": "B", "text": "Breast cancer", "correct": false}, {"label": "C", "text": "Renal Cell carcinoma", "correct": false}, {"label": "D", "text": "Multiple myeloma", "correct": true}], "correct_answer": "D. Multiple myeloma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 48-year-old woman with newly diagnosed HER2-positive invasive ductal carcinoma is started on a neoadjuvant therapy that includes a monoclonal antibody. This antibody specifically binds to the extracellular domain of the HER2 receptor, blocking the activation of downstream signaling pathways involved in cell growth and survival. Additionally, it enhances antibody-dependent cellular cytotoxicity (ADCC), leading to improved immune-mediated destruction of tumor cells. Despite the initial efficacy of the treatment, her oncologist monitors her closely for potential cardiotoxicity, a known side effect of this therapy. Which monoclonal antibody is the patient most likely receiving?", "options": [{"label": "A", "text": "Pertuzumab", "correct": false}, {"label": "B", "text": "Trastuzumab", "correct": true}, {"label": "C", "text": "Cetuximab", "correct": false}, {"label": "D", "text": "Bevacizumab", "correct": false}], "correct_answer": "B. Trastuzumab", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/VvBJg36GLVy5qZ4ihGbw1736436022.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 23 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 26-year-old male patient presents to the OPD. He is travelling to Bangladesh for a period of 12 weeks for work. What is the drug of choice for malaria prophylaxis for this patient?", "options": [{"label": "A", "text": "Primaquine", "correct": false}, {"label": "B", "text": "Doxycycline", "correct": false}, {"label": "C", "text": "Chloroquine", "correct": false}, {"label": "D", "text": "Mefloquine", "correct": true}], "correct_answer": "D. Mefloquine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:774px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causal prophylaxis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Suppressive prophylaxis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The pre-erythrocytic phase (in liver) is the target for this prophylaxis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The schizonts seen in the <span class=\"customMeta\" data-dictid=\"7d53fd92541692777187195e87ab70\">erythrocytic</span> phase are the target for this prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Before the onset of symptoms</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"83be003a3316927771875c9f524aef\">exoerythrocytic</span> phase continues, but clinical disease does not appear</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targets the cause of malaria.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Given to travellers going to countries with malaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs used include <strong>Primaquine, Proguanil, Doxycycline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs used include <strong>Chloroquine. Doxycycline, Mefloquine, Proguanil</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-endemic countries:</p>\n<ul>\n<li><strong>Chloroquine </strong>started 2 weeks before travel and continued for 4 weeks after return (600mg weekly).</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Endemic countries (chloroquine-resistant):</p>\n<ul>\n<li>Travel &lt; 6 weeks: <strong>Doxycycline </strong>started 1 day before travel and continued for 4 weeks after return (100 mg daily).<br/>\n\t\t\t\t </li>\n<li>Travel &gt; 6 weeks: <strong>Mefloquine </strong>started 2 weeks before travel and continued for 4 weeks after return (250 mg weekly).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following diseases with their respective drugs of choice DISEASES DRUGS OF CHOICE 1. Sleeping Sickness (West African Type) - Early Stage A. Fexinidazole 2. Sleeping Sickness (West African Type) - Late Stage B. Suramin 3. Sleeping Sickness (East African Type) - Early Stage C. Nifurtimox-eflornithine combination 4. Sleeping Sickness (East African Type) - Late Stage D. Melarsoprol 5. Chagas Disease E. Benznidazole 6. Pneumocystis jirovecii F. Cotrimoxazole (TMP/SMX)", "options": [{"label": "A", "text": "1-A, 2-C, 3-B, 4-D, 5-E, 6-F", "correct": true}, {"label": "B", "text": "1-D, 2-A, 3-E, 4-C, 5-F, 6-B", "correct": false}, {"label": "C", "text": "1-A, 2-B, 3-C, 4-D, 5-E, 6-F", "correct": false}, {"label": "D", "text": "1-E, 2-C, 3-F, 4-D, 5-B, 6-A", "correct": false}], "correct_answer": "A. 1-A, 2-C, 3-B, 4-D, 5-E, 6-F", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:742px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Early Stage Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Late Stage Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Drug of Choice (DOC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Also Used</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Slepping sickness:</p>\n<p>West African Type</p>\n<p>(T. brucei gambiense)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Fexinidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Nifurtimox-eflornithine combination therapy (NECT)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Fexinidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Pentamidine (in children<br/>\n\t\t\t&lt; 6 yrs old or &lt; 20 kg)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>East African Type</p>\n<p>(T. brucei rhodesiense)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Suramin</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Melarsoprol</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Suramin</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Melarsoprol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Chagas Disease</p>\n<p>(T. cruzi infection)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Benznidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Nifurtimox</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Pneumocystis jirovecii</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Cotrimoxazole (TMP/SMX)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following diseases with their respective drug of choice for treatment. Diseases Drugs of Choice Giardiasis Toxoplasma gondii Balantidium coli Naegleria Pneumocystis pneumonia A. Metronidazole or Tinidazole B. Amphotericin B C. Tetracycline D. Sulfadiazine + Pyrimethamine E. Cotrimoxazole", "options": [{"label": "A", "text": "1-D, 2-A, 3-B, 4-E, 5-C", "correct": false}, {"label": "B", "text": "1-A, 2-D, 3-C, 4-B, 5-E", "correct": true}, {"label": "C", "text": "1-A, 2-B, 3-C, 4-E, 5-D", "correct": false}, {"label": "D", "text": "1-E, 2-B, 3-C, 4-D, 5-A", "correct": false}], "correct_answer": "B. 1-A, 2-D, 3-C, 4-B, 5-E", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Metronidazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Treats amebiasis, giardiasis, <span class=\"customMeta\" data-dictid=\"769f690a2a1692777200123b020cad\">trichomoniasis</span> &amp; other <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections.</li>\n<li>1st line drug in all forms of amebiasis</li>\n<li>Part of combination therapy for H. pylori infection.</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Crosses <span class=\"customMeta\" data-dictid=\"5276da31d11692777195f0e82f5e1d\">placenta</span> and enters breast milk, caution in pregnancy</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Sulfadiazine &amp; Pyrimethamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Along with <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> used as <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for <span class=\"customMeta\" data-dictid=\"aa4b5212fe16927772001223fd8a24\">Toxoplasma</span> encephalitis.</li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"d47433201516927772009cacb59295\">toxoplasmosis</span> in infants and mothers.</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Used for <span class=\"customMeta\" data-dictid=\"8502a8f15e16927771909160b28bf2\">intermittent</span> <span class=\"customMeta\" data-dictid=\"e684325d851692777196af9e64013b\">preventive</span> treatment in pregnancy (IPTp) during the second and third trimesters.</li>\n<li>Teratogenic at high doses.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Tetracycline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"44e54133c716927771821052738ac3\">Balantidium</span> coli</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Not recommended in pregnancy</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Amphotericin B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Liposomal <span class=\"customMeta\" data-dictid=\"2aca559df7169277718182de664e44\">amphotericin B</span> is the drug of choice for <span class=\"customMeta\" data-dictid=\"5dc59b3af1169277719191cbbe6447\">Leishmania</span> donovani.</li>\n<li>Naegleria infections.</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Drug of choice for pregnant and <span class=\"customMeta\" data-dictid=\"5af45ba59c16927771837f3aa7b6d9\">breastfeeding</span> women with visceral leishmaniasis</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Cotrimoxazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>DOC for both the treatment and prevention of <span class=\"customMeta\" data-dictid=\"af71e1cffa16927771950a5fb2c281\">Pneumocystis</span> jirovecii infection, particularly in HIV-positive individuals.</li>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"c07713c3a316927771851e9513868f\">Cyclospora</span> &amp; <span class=\"customMeta\" data-dictid=\"90ef4b285516927771904a048947de\">Isospora</span> infections - <span class=\"customMeta\" data-dictid=\"aaabe672c51692777186a829ebdc0c\">Diarrhea</span> in HIV-positive individuals</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old male patient presents to the clinic with a chronic, non-healing ulcer on his arm. The ulcer started as a small, painless papule and gradually enlarged over the past three months. A biopsy of the lesion shows amastigotes of Leishmania species, confirming a diagnosis of cutaneous leishmaniasis. Which of the following is the drug of choice for treating this cutaneous lesion?", "options": [{"label": "A", "text": "Liposomal Amphotericin B", "correct": true}, {"label": "B", "text": "Pentavalent antimonials", "correct": false}, {"label": "C", "text": "Miltefosine", "correct": false}, {"label": "D", "text": "Paromomycin", "correct": false}], "correct_answer": "A. Liposomal Amphotericin B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:787px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>LEISHMANIASIS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Liposomal <span class=\"customMeta\" data-dictid=\"2aca559df7169277718182de664e44\">Amphotericin B</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>IV</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Drug of choice</strong> for Kala-azar, especially in <strong>pregnancy and children</strong>.10 mg/kg single dose</p>\n<p>Drug of choice for visceral and <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> leishmaniasis </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Miltefosine</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30 days</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Only oral drug for Kala-azar.</strong></p>\n<p>C/I in pregnancy (teratogenic) and children.</p>\n<p><strong>Drug of choice for Post <span class=\"customMeta\" data-dictid=\"a6ac0e2bbf16927771905309bf8e7e\">Kala-azar</span> <span class=\"customMeta\" data-dictid=\"532334711316927771865e5309b763\">dermal</span> <span class=\"customMeta\" data-dictid=\"f60a0a7ad716927771916ed83e3586\">leishmaniasis</span> (PKDL)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Paromomycin</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>IM</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30 days</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Used in combination with <strong>miltefosine</strong> for 30 days (Lower <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> than miltefosine)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Amphotericin B deoxycholate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>IV</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30 days</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Second-line drug for visceral <span class=\"customMeta\" data-dictid=\"f60a0a7ad716927771916ed83e3586\">leishmaniasis</span> according to the NVBDCP.</p>\n<p>Effective for antimony-resistant cases and for <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Sodium stibogluconate</strong></p>\n<p><strong>(Pentavalent antimonial)</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>IV</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30 days</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Least preferred</strong> treatment for <strong>Kala-azar</strong> due to <strong>resistance</strong>. Initially made for kala-azar, also known as <span class=\"customMeta\" data-dictid=\"5050869d8216927771958b19b53d5a\">pentavalent</span> antimonial. Contains <span class=\"customMeta\" data-dictid=\"bbff4e22b316927771813223814d80\">antimony</span> (Sb), which is toxic to Leishmania.</p>\n<p><strong>S/E:</strong></p>\n<ol>\n<li>QT prolongation</li>\n<li>Pancreatitis</li>\n<li>Nephrotoxic</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old female presents with intermittent abdominal pain, diarrhea, and flatulence for two weeks after consuming local street food. Examination reveals mild lower abdominal tenderness. Stool tests show Entamoeba histolytica cysts, confirming luminal amebiasis. What is the drug of choice for treating luminal amebiasis in this patient?", "options": [{"label": "A", "text": "Metronidazole", "correct": false}, {"label": "B", "text": "Tinidazole", "correct": false}, {"label": "C", "text": "Paromomycin", "correct": true}, {"label": "D", "text": "Quiniodochlor", "correct": false}], "correct_answer": "C. Paromomycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:559px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Additional points &amp; S/E</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Luminal <span class=\"customMeta\" data-dictid=\"98b8ba70fb1692777181c93f7d0685\">Amebicidal</span> Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Paromomycin</p>\n<p><strong>(DOC)</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>An Aminoglycoside</p>\n<p><strong>Luminal agent for amebiasis.</strong></p>\n</td>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>An <strong>alternative drug for Giardiasis</strong>, especially in the first <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy where <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">metronidazole</span> is C/I.</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Diloxanide furoate</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Mild intestinal amebiasis</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Furoate is the active <span class=\"customMeta\" data-dictid=\"708d2a81e4169277719263f5f17227\">moiety</span> that kills <em>Entamoeba</em></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Quiniodochlor</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Rarely used due to dangerous <strong>side effects such as SMON</strong> (Subacute myelo-optico-neuropathy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Iodoquinol</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Contains <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> and can cause <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> abnormalities</strong> and allergy</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Tissue <span class=\"customMeta\" data-dictid=\"98b8ba70fb1692777181c93f7d0685\">Amebicidal</span> Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Metronidazole</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> \n\t\t\t<ol>\n<li><strong>DOC for all forms of amebiasis</strong></li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"6000beebf41692777181fb008e4936\">amebic colitis</span> and liver abscess</li>\n<li><strong>Penetrates well into body tissues and fluids </strong>including <span class=\"customMeta\" data-dictid=\"9a1e50b8221692777201b95b66c9de\">vaginal</span> secretions, seminal fluid, saliva, breast milk, and <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid.</li>\n</ol>\n</td>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ol>\n<li>Effective against <span class=\"customMeta\" data-dictid=\"b444d7821b16927771873fcd26a46e\">Entamoeba</span> histolytica trophozoites but less effective against cysts.</li>\n<li><strong>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in Entamoeba</strong></li>\n<li>Treats giardiasis, trichomoniasis, and <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections</li>\n<li>Used in combination therapy for H. pylori infection</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Tinidazole</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Amebic <span class=\"customMeta\" data-dictid=\"e6955110f21692777184d2090a400c\">colitis</span> and liver abscess</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Also used to treat: <strong>Trichomoniasis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Ornidazole</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Acute amoebic dysentery</strong></p>\n</td>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Secnidazole</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Emetine</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Acute amoebic <span class=\"customMeta\" data-dictid=\"83b2863439169277718675fa3b9b00\">dysentery</span> or <strong>amoebic liver <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> in patients not tolerating metronidazole</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Directly acting amoebicide that kills trophozoites but has no effect on cysts.</p>\n<p><strong>Side effects include <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> and cardiotoxicity.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Chloroquine</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Amoebic liver abscess</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Kills the liver stage of <em>Entamoeba histolytica</em></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:472px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Luminal <span class=\"customMeta\" data-dictid=\"98b8ba70fb1692777181c93f7d0685\">Amebicidal</span> Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Tissue <span class=\"customMeta\" data-dictid=\"98b8ba70fb1692777181c93f7d0685\">Amebicidal</span> Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Paromomycin</li>\n<li>Diloxanide furoate</li>\n<li>Quiniodochlor</li>\n<li>Iodoquinol</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Metronidazole or its congeners (Tinidazole, Ornidazole)</li>\n<li>Emetine</li>\n<li>Chloroquine</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents with symptoms of severe malaria. He complains of high fever, chills, profuse sweating, altered mental status, and jaundice. Laboratory investigations reveal thrombocytopenia, elevated serum creatinine, and metabolic acidosis. A blood smear confirms the presence of Plasmodium falciparum infection. Which of the following antimalarial medications is the most appropriate initial treatment for this patient's complicated malaria?", "options": [{"label": "A", "text": "Chloroquine", "correct": false}, {"label": "B", "text": "Artemether", "correct": false}, {"label": "C", "text": "Quinine", "correct": false}, {"label": "D", "text": "Artesunate", "correct": true}], "correct_answer": "D. Artesunate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old male traveller presents to the clinic for malaria prophylaxis before his trip to a region where Plasmodium vivax is endemic. He has a history of G6PD deficiency. Which of the following antimalarial medications is safe in individuals with G6PD deficiency?", "options": [{"label": "A", "text": "Quinine", "correct": false}, {"label": "B", "text": "Primaquine", "correct": false}, {"label": "C", "text": "Proguanil", "correct": false}, {"label": "D", "text": "Mefloquine", "correct": true}], "correct_answer": "D. Mefloquine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:602px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antimalarials safe in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antimalarials NOT safe in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mefloquine (safest)<strong>(Option D)</strong></li>\n<li>Chloroquine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Quinine <strong>(Option A ruled out)</strong></li>\n<li>Primaquine<strong> (Option B ruled out)</strong></li>\n<li>Proguanil<strong> (Option C ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VFXnolBMmExX3MPYeUwj1745663041.mp3", "video": ""}, {"text": "A 35-year-old male traveller returns from a recent trip to a malaria-endemic region. He presents to the clinic with complaints of blurred vision and halos around lights. He reports taking chloroquine prophylaxis during his trip. Which of the following ophthalmic side effects is most likely associated with his antimalarial medication?", "options": [{"label": "A", "text": "Optic neuritis", "correct": false}, {"label": "B", "text": "Corneal deposits", "correct": true}, {"label": "C", "text": "Retinal detachment", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "B. Corneal deposits", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:663px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CHLOROQUINE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chloroquine accumulates in <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> compartments of parasite-infected cells, disrupting <span class=\"customMeta\" data-dictid=\"d4fff554a316927771885dc8700abe\">heme</span> polymerisation and inhibiting <span class=\"customMeta\" data-dictid=\"a59b97ce831692777194f6c0160f15\">parasite</span> growth and replication.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to mutations in genes <span class=\"customMeta\" data-dictid=\"b989cb3b0d1692777187dd7965b4d3\">encoding</span> transporters involved in <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> and efflux, reducing <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> accumulation within parasites.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Malaria Treatment and Prophylaxis</li>\n<li>Amoebiasis</li>\n<li>Leprae reaction</li>\n<li>Giardiasis</li>\n<li>Autoimmune Diseases (RA, SLE)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>S/E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ophthalmic: Bull's eye maculopathy, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"e5c2f7896c16927771998d7eb7f8f2\">sub</span> capsular cataract, <span class=\"customMeta\" data-dictid=\"301da8b9181692777202486306bbd2\">vortex</span> keratopathy, corneal deposits</li>\n<li>Gastrointestinal: Nausea, vomiting, diarrhea</li>\n<li>Skin: Itching, rash, photosensitivity</li>\n<li>Neuropsychiatric: Agitation, confusion, hallucinations</li>\n<li>Cardiac: QT prolongation, <span class=\"customMeta\" data-dictid=\"6e6dd7aed216927771831ebdf9703c\">cardiomyopathy</span> (rare)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antimalarials is safe to use in all trimesters?", "options": [{"label": "A", "text": "Primaquine", "correct": false}, {"label": "B", "text": "Artemisinin", "correct": false}, {"label": "C", "text": "Clindamycin", "correct": true}, {"label": "D", "text": "Doxycycline", "correct": false}], "correct_answer": "C. Clindamycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:734px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>Safe in all trimesters</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>Contraindicated in 1st <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> only</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>Contraindicated in all trimesters</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Chloroquine</li>\n<li>Quinine</li>\n<li>Clindamycin <strong>(Option C)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Artesunate combination therapy (ACT) <strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Primaquine <strong>(Option A)</strong></li>\n<li>Doxycycline <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:847px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>P. Vivax/ovale</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>P. falciparum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<p><strong>Complicated malaria</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Primaquine contraindicated.</li>\n<li>It is not cured; <span class=\"customMeta\" data-dictid=\"b4b361c37616927771979541177070\">relapse</span> is treated after pregnancy.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Chloroquine resistance is seen.</li>\n<li>1st trimester: <strong>Quinine + clindamycin</strong></li>\n<li>2nd <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> onwards: <strong>ACT</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #9a9a9a; border-left:1px solid #9a9a9a; border-right:1px solid #9a9a9a; border-top:1px solid #9a9a9a; vertical-align:top\">\n<ul>\n<li>Life-threatening to the mother</li>\n<li>All life-saving measures are taken despite teratogenicity</li>\n<li><strong>IV Artesunate</strong> is used regardless of trimester</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drug combinations is used to treat malaria infections due to multiple plasmodium species?", "options": [{"label": "A", "text": "Quinine + Doxycycline", "correct": false}, {"label": "B", "text": "Chloroquine + Primaquine", "correct": false}, {"label": "C", "text": "Parenteral ACT + Oral ACT", "correct": false}, {"label": "D", "text": "ACT+ Primaquine", "correct": true}], "correct_answer": "D. ACT+ Primaquine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:575px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scenario</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uncomplicated P. Vivax malaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chloroquine 25 mg/kg over 3 days (10-10-5) + Primaquine oral 0.25 mg/kg for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complicated malaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Parenteral ACT-Artesunate i.v. given for 2 days, followed by a full course of oral ACT.</p>\n\t\t\t \n\n\t\t\t<p>OR</p>\n\t\t\t \n\n\t\t\t<p>Parenteral <span class=\"customMeta\" data-dictid=\"e19b9eeec016927771979899edd580\">quinine</span> i.v. given for 2 days, and oral <span class=\"customMeta\" data-dictid=\"e19b9eeec016927771979899edd580\">quinine</span> given for 5 days. Add on oral doxycycline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mixed infection </strong><br/>\n<strong>(P. vivax/ovale/falciparum)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACT+ Primaquine for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st trimester: <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">Parenteral</span> quinine</p>\n<p>2nd and 3rd trimester: <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">Parenteral</span> artemisinin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following mechanisms is characteristic of albendazole (benzimidazole-class) anti-helminthic drugs?", "options": [{"label": "A", "text": "Inhibition of acetylcholinesterase", "correct": false}, {"label": "B", "text": "Activation of GABA receptors", "correct": false}, {"label": "C", "text": "Inhibition of microtubule synthesis", "correct": true}, {"label": "D", "text": "Blockade of nicotinic acetylcholine receptors", "correct": false}], "correct_answer": "C. Inhibition of microtubule synthesis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:689px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Microtubule inhibitors </strong><br/>\n<strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Spastic paralysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Flaccid paralysis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li style=\"text-align:center\">Benzimidazole group:\n\t\t\t\t<ul>\n<li>Albendazole</li>\n<li>Mebendazole</li>\n<li>Triclabendazole</li>\n<li>Thiabendazole</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li style=\"text-align:center\">Praziquantel: <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> influx</li>\n<li style=\"text-align:center\">Levamisole: <span class=\"customMeta\" data-dictid=\"c10496dcc416927771937d7280d782\">Nicotinic</span> muscle <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation</li>\n<li style=\"text-align:center\">Pyrantel pamoate: muscle depolarisation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li style=\"text-align:center\">Piperazine: Opens GABA-A Cl⁻ channel</li>\n<li style=\"text-align:center\">Ivermectin: Opens <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> Cl⁻ channel</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is used for an effective radical cure in malarial fever?", "options": [{"label": "A", "text": "Artemisinin", "correct": false}, {"label": "B", "text": "Mefloquine", "correct": false}, {"label": "C", "text": "Atovaquone", "correct": false}, {"label": "D", "text": "Primaquine", "correct": true}], "correct_answer": "D. Primaquine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Cure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radical Cure</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erythrocytic schizonts are killed to prevent an episode of malarial fever.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypnozoites(dormant stage) are killed to prevent <span class=\"customMeta\" data-dictid=\"b4b361c37616927771979541177070\">relapse</span> of malarial fever.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen in all <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">plasmodium</span> species</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen in P. Ovale and P. Vivax</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All drugs are effective<strong> except primaquine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DOC: Primaquine and Tafenoquine</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following stages of malaria with the corresponding drugs used Stages of malaria Drugs 1. Sporozoites A. Tafenoquine, Primaquine 2. Hepatic schizogony B. Mosquirix vaccine 3. Gametocytes C. Proguanil, Primaquine 4. Hypnozoites D. Only primaquine", "options": [{"label": "A", "text": "1-c, 2-d, 3-a, 4-b", "correct": false}, {"label": "B", "text": "1-d, 2-a, 3-b, 4-c", "correct": false}, {"label": "C", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "D", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}], "correct_answer": "D. 1-b, 2-c, 3-d, 4-a", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:684px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stages of malaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs acting on them</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic <span class=\"customMeta\" data-dictid=\"ea48e9bce8169277719849db222571\">schizogony</span> (pre-erythrocytic phase)</p>\n<p><em>Causal prophylaxis</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Primaquine</li>\n<li>Proguanil</li>\n<li>Doxycycline</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erythrocytic schizogony</p>\n<p><em>Clinical cure</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All drugs except primaquine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypnozoites(dormant form)</p>\n<p><em>Radical cure</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Primaquine</li>\n<li>Tafenoquine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gametocytes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Primaquine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sporozoites</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mosquirix vaccine</p>\n<ul>\n<li>RTS,S/AS01 vaccine</li>\n<li>Given i.m. in children</li>\n<li>Sporozoites are coated in HbSAg, leading to a T-cell response against the sporozoites.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UIuB6dSqwiGWVBiEyVIr1748861034.mp3", "video": ""}, {"text": "A 35-year-old male patient is admitted to the hospital with high fever, chills, and severe headache. Upon examination and laboratory tests, he is diagnosed with P.falciparum malaria. The patient's medical history reveals that he has schizophrenia and is currently on antipsychotic medication. Considering the patient's medical history, which of the following antimalarial treatments is contraindicated for this patient?", "options": [{"label": "A", "text": "Artemether-lumefantrine", "correct": false}, {"label": "B", "text": "Quinine", "correct": false}, {"label": "C", "text": "Mefloquine", "correct": true}, {"label": "D", "text": "Atovaquone-proguanil", "correct": false}], "correct_answer": "C. Mefloquine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KW3fDZUtZURFVg4rPPOF1736484445.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:883px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>ANTI-MALARIAL DRUGS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Drugs &amp; Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Chloroquine Group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Inhibits the conversion of <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> to <span class=\"customMeta\" data-dictid=\"9ac308dc241692777188bda8807f26\">hemozoin</span> in parasites</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Chloroquine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), <span class=\"customMeta\" data-dictid=\"6134259b6e1692777191ec808c0ca6\">lepra</span> reaction, <span class=\"customMeta\" data-dictid=\"afad60190f1692777182663499dc42\">atopic</span> dermatitis</p>\n\t\t\t \n\n\t\t\t<p><strong>Amodiaquine and Piperaquine:</strong> Treatment of malaria.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Chloroquine can cause <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> toxicity, including bull's eye maculopathy, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataracts, and <span class=\"customMeta\" data-dictid=\"301da8b9181692777202486306bbd2\">vortex</span> keratopathy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Artemisinin Group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Forms free radicals that damage <span class=\"customMeta\" data-dictid=\"a59b97ce831692777194f6c0160f15\">parasite</span> proteins and DNA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Artesunate:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), including complicated <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (IV administration).</p>\n\t\t\t \n\n\t\t\t<p><strong>Artemether, Arteether, and Arterolane:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Artemisinin is obtained from the Chinese herb <em>Artesuna annua</em>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Quinoline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> channels in parasites, leading to paralysis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Quinine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), including complicated <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (IV administration).</p>\n\t\t\t \n\n\t\t\t<p><strong>Quinidine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure) and used as a Class <span class=\"customMeta\" data-dictid=\"45d7632a0216927771898df908d43b\">IA</span> <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> drug.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Quinine is obtained from the <span class=\"customMeta\" data-dictid=\"98e1581310169277718479249e19df\">cinchona</span> plant and can cause <span class=\"customMeta\" data-dictid=\"4df633b90b1692777194f240944eb4\">ototoxicity</span> (cinchonism), hypoglycemia, QT prolongation, hypotension, and diarrhea.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Primaquine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Disrupts the parasite's <span class=\"customMeta\" data-dictid=\"d416281a201692777187899c00aed8\">electron</span> transport chain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Radical cure of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> caused by <em>P. vivax</em> and <em>P. ovale</em> (targets hypnozoites).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Primaquine is not effective against <span class=\"customMeta\" data-dictid=\"7d53fd92541692777187195e87ab70\">erythrocytic</span> <span class=\"customMeta\" data-dictid=\"ea48e9bce8169277719849db222571\">schizogony</span> and, therefore not used for clinical cure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Antifolates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">dihydrofolate</span> reductase, essential for <span class=\"customMeta\" data-dictid=\"a59b97ce831692777194f6c0160f15\">parasite</span> <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> synthesis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pyrimethamine and Sulfadoxine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), typically in combination with artesunate.</p>\n\t\t\t \n\n\t\t\t<p><strong>Proguanil:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure) and prophylaxis.</p>\n\t\t\t \n\n\t\t\t<p><strong>Sulfadoxine:</strong> Treatment of malaria</p>\n<p>Typically in combination with artesunate.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>These drugs should be combined with <span class=\"customMeta\" data-dictid=\"699ed0930f1692777203617cf3f0c7\">folinic acid</span> (tetrahydrofolate) to prevent megaloblastic anemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Antibiotics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Various mechanisms <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> <span class=\"customMeta\" data-dictid=\"a59b97ce831692777194f6c0160f15\">parasite</span> protein synthesis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Doxycycline:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure and causal prophylaxis), <span class=\"customMeta\" data-dictid=\"af71e1cffa16927771950a5fb2c281\">pneumocystis</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (in combination with primaquine).</p>\n\t\t\t \n\n\t\t\t<p><strong>Clindamycin:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), <span class=\"customMeta\" data-dictid=\"af71e1cffa16927771950a5fb2c281\">pneumocystis</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (in combination with primaquine), toxoplasmosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Doxycycline is C/I in pregnancy and children &lt;8 years old.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Others</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Mefloquine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure and suppressive prophylaxis), particularly chloroquine-resistant strains.</p>\n\t\t\t \n\n\t\t\t<p><strong>Lumefantrine:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure), particularly with <span class=\"customMeta\" data-dictid=\"d145aa2b061692777182012254937c\">artemether</span> in northeastern Indian states.</p>\n\t\t\t \n\n\t\t\t<p><strong>Tafenoquine:</strong> Radical cure of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> caused by <em>P. vivax</em> and <em>P. ovale</em>.</p>\n\t\t\t \n\n\t\t\t<p><strong>Atovaquone:</strong> Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> (clinical cure) and <span class=\"customMeta\" data-dictid=\"af71e1cffa16927771950a5fb2c281\">pneumocystis</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (in combination with dapsone).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mefloquine has a high risk of neuropsychiatric symptoms and is C/I in cerebral malaria.</p>\n<p>Lumefantrine can cause QT prolongation.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male patient presents with complaints of intense itching, especially at night, and a rash that has developed over the past few weeks. On examination, multiple small, red papules and burrows are noted in the interdigital spaces of his hands, wrists, and waistline. The patient mentions that his wife and children are also experiencing similar symptoms. Which of the following is the most appropriate treatment for this patient's condition?", "options": [{"label": "A", "text": "Lindane", "correct": false}, {"label": "B", "text": "Permethrin", "correct": true}, {"label": "C", "text": "Sulfur", "correct": false}, {"label": "D", "text": "Dicophane", "correct": false}], "correct_answer": "B. Permethrin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:773px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>DRUGS FOR SCABIES</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>5 % <span class=\"customMeta\" data-dictid=\"81d6ac3d201692777195c6de09e22c\">Permethrin</span> (1st line)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>A <span class=\"customMeta\" data-dictid=\"e683f9ba2616927771965cfe8c3d21\">pyrethroid</span> <span class=\"customMeta\" data-dictid=\"f6cead7b60169277719027472f0506\">insecticide</span> that is highly effective, with nearly 100% cure rates in <span class=\"customMeta\" data-dictid=\"88ce8f7ff416927771985430dd4bd0\">scabies</span> after a single application.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Lindane (2nd line)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>A <span class=\"customMeta\" data-dictid=\"583de7632e16927771834054d1be58\">broad-spectrum</span> insecticide, but less effective than <span class=\"customMeta\" data-dictid=\"81d6ac3d201692777195c6de09e22c\">permethrin</span> and has a higher risk of <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> toxicity, particularly in children.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Benzyl <span class=\"customMeta\" data-dictid=\"08e2c52baf16927771829caf1223c3\">Benzoate</span> (2nd line)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Minimally absorbed through the skin and has low <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> but can cause neurological symptoms in children.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Crotamiton (2nd line)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Less <span class=\"customMeta\" data-dictid=\"607476ab371692777196d0cb2f13bc\">prone</span> to cause skin <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> and has low <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> but has produced lower cure rates in scabies.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Sulfur</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>The oldest <span class=\"customMeta\" data-dictid=\"ad74129e5b1692777198dddbb35acc\">scabicide</span> but has several disadvantages, including messy application, unpleasant odour, and the need for repeated applications.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Dicophane (DDT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Can be absorbed through the skin and cause <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> toxicity, rarely used due to potential side effects and safer alternatives.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Ivermectin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>An oral medication that is highly effective in treating scabies.</p>\n<p>Not to be given to children &lt;5 yrs old, pregnant, or <span class=\"customMeta\" data-dictid=\"5af45ba59c16927771837f3aa7b6d9\">breastfeeding</span> women.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following diseases to their respective drug of choice for treatment. DISEASES DRUG OF CHOICE 1. Diphyllobothriasis A. Albendazole 2. Neurocysticercosis B. Praziquantel 3. Lymphatic Filariasis C. Diethylcarbamazine (DEC) 4. Liver Fluke Infection D. Triclabendazole", "options": [{"label": "A", "text": "1-B, 2-A, 3-C, 4-D", "correct": true}, {"label": "B", "text": "1-C, 2-B, 3-D, 4-A", "correct": false}, {"label": "C", "text": "1-D, 2-C, 3-B, 4-A", "correct": false}, {"label": "D", "text": "1-A, 2-D, 3-B, 4-C", "correct": false}], "correct_answer": "A. 1-B, 2-A, 3-C, 4-D", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:771px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Other Information</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Cestodes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Praziquantel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for all cestodes.</p>\n<p>C/I in <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> cysticercosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Niclosamide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>2nd line drug for cestodes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Albendazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"dfbc87c3ea1692777186b8daca1935\">Echinococcus</span> (Dog tapeworm) - Causes <span class=\"customMeta\" data-dictid=\"cc96ad6655169277718944f7ffe9ae\">Hydatid</span> cyst</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Neurocysticercosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Albendazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>First, corticosteroids are given to prevent inflammation, followed by <span class=\"customMeta\" data-dictid=\"262fd93a6e16927771811a1da8a767\">Albendazole</span> to kill the worms. Corticosteroids and anti-epileptic drugs (Phenytoin) are then continued for six months.</p>\n<p>Starting with <span class=\"customMeta\" data-dictid=\"262fd93a6e16927771811a1da8a767\">Albendazole</span> alone can trigger an <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> reaction</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"8\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Nematodes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Albendazole</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for all Nematodes, <strong>except</strong> Strongyloides, <span class=\"customMeta\" data-dictid=\"6a297d01751692777194efc304d24f\">Onchocerca</span> volvulus, Wuchereria, <span class=\"customMeta\" data-dictid=\"fde28feeb31692777183995b9efd0c\">Brugia</span> malayi/timori, Loa-loa, Dracunculus, and Microsporidium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Mebendazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Ivermectin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"8ca979e559169277719979fc412da6\">Strongyloides</span> (Thread worm) and <span class=\"customMeta\" data-dictid=\"6a297d01751692777194efc304d24f\">Onchocerca</span> <span class=\"customMeta\" data-dictid=\"061f9a880e1692777202e47dbb3d3f\">volvulus</span> (causes river blindness);</p>\n<p>Also used for Scabies.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>DEC (Diethylcarbamazine)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for Wuchereria, <span class=\"customMeta\" data-dictid=\"fde28feeb31692777183995b9efd0c\">Brugia</span> malayi/timori, and Loa-loa;</p>\n<p>Add <span class=\"customMeta\" data-dictid=\"b16589305a1692777190ce9d440182\">Ivermectin</span> or <span class=\"customMeta\" data-dictid=\"262fd93a6e16927771811a1da8a767\">Albendazole</span> to DEC.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Metronidazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"06949762821692777186b99cb666d9\">Dracunculus</span> (Guinea worm)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Pyrantel pamoate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>2nd line drug for <span class=\"customMeta\" data-dictid=\"cdb3a0ba391692777193b0bdedf9ba\">Nematode</span> infection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Piperazine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Used for treatment of <span class=\"customMeta\" data-dictid=\"4d47d123c5169277718253a3a20bad\">Ascariasis</span> and Entrobius</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Levamisole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>2nd line drug for treatment of Ascariasis;</p>\n<p>Given in the treatment of steroid-resistant <span class=\"customMeta\" data-dictid=\"7063996c3816927771930f70c92eb4\">nephrotic</span> syndrome</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Trematodes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Praziquantel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for all trematodes;</p>\n<p>For <span class=\"customMeta\" data-dictid=\"117c2d627d169277719882df872185\">Schistosomia</span> hematobium: <strong>Praziquantel + Metrifonate;</strong></p>\n<p>For <span class=\"customMeta\" data-dictid=\"117c2d627d169277719882df872185\">Schistosomia</span> mansoni: <strong>Praziquantel + Oxamniquine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Triclabendazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"1f2ca380d4169277720255cecb8da3\">Fasciola</span> hepatica (Liver fluke)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Microsporidium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Albendazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>May cause Keratitis, which should be treated with <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> - <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> fumagillin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old woman visits a tropical medicine clinic after returning from a humanitarian trip to sub-Saharan Africa. She reports experiencing intense itching and skin changes. Blood tests reveal the presence of Loa loa microfilariae at a level of 40,000 microfilariae/mL of blood. Which of the following medications is contraindicated in this patient?", "options": [{"label": "A", "text": "Ivermectin", "correct": true}, {"label": "B", "text": "Pyrantel pamoate", "correct": false}, {"label": "C", "text": "Piperazine", "correct": false}, {"label": "D", "text": "Niclosamide", "correct": false}], "correct_answer": "A. Ivermectin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:699px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Ivermectin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Ivermectin</strong> immobilises affected organisms by inducing a <span class=\"customMeta\" data-dictid=\"949f14b6e4169277720075eaacbf1f\">tonic</span> <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> of the musculature, activating glutamate-gated Cl⁻ channels found only in invertebrates.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> \n\t\t\t<p><strong>Therapeutic Uses</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"5d263488671692777194c134f2c1a1\">onchocerciasis</span> in adults and children ≥5 yrs old.</li>\n<li>As effective as DEC for controlling <span class=\"customMeta\" data-dictid=\"4fb6bd90f016927771918d4a2993ed\">lymphatic</span> filariasis.</li>\n<li>Preferred drug for treating human strongyloidiasis.</li>\n<li>First-line treatment for <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> <span class=\"customMeta\" data-dictid=\"48bab7934a16927771917c5a2bf7e2\">larva</span> migrans caused by dog or cat hookworms.</li>\n<li>Option for treating <span class=\"customMeta\" data-dictid=\"88ce8f7ff416927771985430dd4bd0\">scabies</span> and head lice.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>In <span class=\"customMeta\" data-dictid=\"af58e514a61692777202149d26f8a1\">filarial</span> infection, causes a Mazzotti-like reaction to dying microfilariae.</li>\n<li>Risk of permanent disability and encephalopathies in patients with heavy <em>L. loa</em> <span class=\"customMeta\" data-dictid=\"1e300ef0e21692777192fbb44da080\">microfilaria</span> (≥ 30,000 per mm of blood)</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Precautions and Contraindications</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>C/I in conditions with an impaired blood-brain barrier, such as African <span class=\"customMeta\" data-dictid=\"edd7fdfb5916927772002c4eec4065\">trypanosomiasis</span> and meningitis, due to its effects on GABA receptors.</li>\n<li>Not approved for children &lt;15 kg, pregnant women, or lactating women.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:784px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Clinical Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Other Information</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Pyrantel Pamoate</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Depolarisation of muscle by opening non-selective <span class=\"customMeta\" data-dictid=\"299c6a693916927771832f0615b65d\">cation</span> channels in worms, leading to <span class=\"customMeta\" data-dictid=\"1ce806f0111692777198eedf1b5824\">spastic</span> paralysis.</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>2nd line drug for Nematodes</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Piperazine</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Opens - GABA-A Cl channel , hyperpolarizes muscle &amp; causes <span class=\"customMeta\" data-dictid=\"d28003a82c1692777202475273e346\">flaccid</span> paralysis.</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>To treat Ascariasis and Enterobius</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>C/I in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> disease and epilepsy.</li>\n<li>Safe in pregnancy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Niclosamide</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Calcium influx causing <span class=\"customMeta\" data-dictid=\"1ce806f0111692777198eedf1b5824\">spastic</span> muscle paralysis</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>2nd line drug for cestodes.</li>\n<li>Used to treat intestinal T. solium infections, especially with suspected neurocysticercosis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<ul>\n<li>C/I in <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"183a3f89521692777185a6d0144d6c\">cysticercosis</span> as it causes eye <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> leading to blindness</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is contraindicated in ocular cysticercosis?", "options": [{"label": "A", "text": "Levamisole", "correct": false}, {"label": "B", "text": "Oxamniquine", "correct": false}, {"label": "C", "text": "Praziquantel", "correct": true}, {"label": "D", "text": "Metrifonate", "correct": false}], "correct_answer": "C. Praziquantel", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PRAZIQUANTEL</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> influx into the tapeworm, resulting in paralysis, <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> from the intestine, and death.</p>\n<p>At higher concentrations, it breaks down the tapeworm's outer layer.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extensively metabolised in the liver (⇒ less bioavailability)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Highly effective for all human <span class=\"customMeta\" data-dictid=\"a4b3ac874d16927772008f9446d140\">tapeworm</span> infections, especially for T. solium cysticercosis, where <span class=\"customMeta\" data-dictid=\"c2907c9f0016927771914eedf733dd\">larvae</span> invade tissues like the muscles, and skin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>In neurocysticercosis, killing <span class=\"customMeta\" data-dictid=\"7a9967010c16927771914174ab4e92\">larval</span> cysts in the brain can trigger inflammation, leading to seizures and <strong>￪</strong>intracranial pressure.</li>\n<li>C/I in <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"183a3f89521692777185a6d0144d6c\">cysticercosis</span> due to the risk of intense <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> response, tissue damage, and vision loss</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mjE3UgZiaTPQQU5GnIzU1746257851.mp3", "video": ""}, {"text": "An 18-month-old child presents with complaints of recurrent abdominal discomfort, irritability, and poor weight gain. Upon examination, the child appears pale with no signs of acute distress. Stool examination reveals the presence of ova and parasites. Which of the following medications is the most appropriate for the treatment of this child's condition?", "options": [{"label": "A", "text": "Mebendazole", "correct": false}, {"label": "B", "text": "Pyrantel pamoate", "correct": false}, {"label": "C", "text": "Albendazole", "correct": true}, {"label": "D", "text": "Praziquantel", "correct": false}], "correct_answer": "C. Albendazole", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is false regarding the benzimidazole class of antihelminths?", "options": [{"label": "A", "text": "Acts by inhibiting microtubule synthesis", "correct": false}, {"label": "B", "text": "High bioavailability", "correct": true}, {"label": "C", "text": "Acts by reducing glucose transport", "correct": false}, {"label": "D", "text": "Contraindicated in those less than 1 year of age", "correct": false}], "correct_answer": "B. High bioavailability", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:690px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Benzimidazoles (Albendazole, Mebendazole, Triclabendazole)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Microtubule <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> and subsequent <span class=\"customMeta\" data-dictid=\"5744dac7511692777186db6f8e0c28\">disruption</span> of <span class=\"customMeta\" data-dictid=\"17827b01cc1692777184bf6f27f6ad\">cell division</span> <strong>(Option A)</strong></li>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> transport <strong>(Option C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Low <span class=\"customMeta\" data-dictid=\"cf91922bb816927771839a51f2d1e6\">bioavailability</span> <strong>(Option B is the false statement)</strong></li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> when taken with <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> meals</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anorexia, nausea/vomiting, dizziness</li>\n<li>Hypersensitvity</li>\n<li>Aplastic anemia</li>\n<li>Hepatotoxicity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contraindicated in 1st trimester</li>\n<li>Given in 2nd and 3rd trimesters (Only in severe cases)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Children</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Albendazole: C/I in &lt;1 year of age <strong>(Option D)</strong></li>\n<li>Mebendazole: C/I in &lt;2 years of age</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose for deworming</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Albendazole\n\t\t\t\t<ul>\n<li>1-2 years: 200mg oral tablet</li>\n<li>&gt;2 years: 400mg oral tablet</li>\n</ul>\n</li>\n<li>Mebendazole\n\t\t\t\t<ul>\n<li>&gt;2 years: 100mg oral tablet</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Bedaquiline", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old male patient with a history of TB presents for a follow-up appointment. He has been compliant with his anti-TB medications. However, his recent sputum culture results indicate the persistence of TB bacilli. Which of the following mechanisms of resistance is not seen with isoniazid use?", "options": [{"label": "A", "text": "KatG gene mutation", "correct": false}, {"label": "B", "text": "KasA gene mutation", "correct": false}, {"label": "C", "text": "InhA gene overexpression", "correct": false}, {"label": "D", "text": "PncA gene mutation", "correct": true}], "correct_answer": "D. PncA gene mutation", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/j6pEXmF0GRh1F0PXjCyI1736483745.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:812px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of resistance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>KatG gene mutation</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Encodes catalase-peroxidase, which activates isoniazid. <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">Mutation</span> leads to failure of drug activation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>KasA gene <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>KasA is involved in mycolic acid <span class=\"customMeta\" data-dictid=\"3e53f6980f1692777187044dd3f9e7\">elongation</span> and can contribute to INH resistance, though it's a less common mechanism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>InhA gene overexpression (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>InhA is the target <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> (enoyl-ACP reductase) involved in mycolic acid synthesis. Overexpression leads to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> drug binding.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male currently on treatment for leprosy presents to the emergency department with a sudden onset of new lesions and enlargement of existing lesions. They appear red, swollen and tender to the touch. What is the type of hypersensitivity reaction seen in this condition?", "options": [{"label": "A", "text": "Type 1 hypersensitivity reaction", "correct": false}, {"label": "B", "text": "Type 2 hypersensitivity reaction", "correct": false}, {"label": "C", "text": "Type 3 hypersensitivity reaction", "correct": true}, {"label": "D", "text": "Type 4 hypersensitivity reaction", "correct": false}], "correct_answer": "C. Type 3 hypersensitivity reaction", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type 1 <span class=\"customMeta\" data-dictid=\"6134259b6e1692777191ec808c0ca6\">lepra</span> reaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type 2 <span class=\"customMeta\" data-dictid=\"6134259b6e1692777191ec808c0ca6\">lepra</span> reaction</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>aka <span class=\"customMeta\" data-dictid=\"82343f61171692777197b4a08bc719\">Reversal</span> reaction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>aka <span class=\"customMeta\" data-dictid=\"f0f3e105661692777187df507b1f26\">Erythema</span> nodosum leprosum</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Delayed <span class=\"customMeta\" data-dictid=\"26a46d0aaa169277720147f4f40f57\">type 4</span> <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type 3 <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction involving immune complex deposition</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cutaneous ulceration, multiple nerve involvement with swollen, painful, and tender nerves occur suddenly</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abrupt onset; existing lesions enlarge, become red, swollen, and painful.</p>\n<p>Several new lesions may appear.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n<ul>\n<li>Don't stop MDT</li>\n<li>Clofazimine or</li>\n<li>DOC: Corticosteroids (Prednisone)</li>\n<li>In mild hypersensitivity: Chloroquine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n<ul>\n<li>Don't stop MDT</li>\n<li>Clofazimine or</li>\n<li>DOC: Corticosteroids (Prednisone) or</li>\n<li>Thalidomide (corticosteroid resistant cases)</li>\n<li>In mild hypersensitivity: Chloroquine</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the drug of choice for post-exposure prophylaxis in leprosy?", "options": [{"label": "A", "text": "Rifampin 600 mg", "correct": true}, {"label": "B", "text": "Clofazimine 300 mg", "correct": false}, {"label": "C", "text": "Dapsone 100 mg", "correct": false}, {"label": "D", "text": "Clarithromycin 500 mg", "correct": false}], "correct_answer": "A. Rifampin 600 mg", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:417px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Age group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose of Rifampicin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> ≥ 15 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>600 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10–14 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>450 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6–9 years (Weight ≥20 Kg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>300 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2–5 years (Weight ≤20 Kg)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10-15 mg/Kg</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BCG</strong></p>\n<p>(Bacillus Calmette Guerin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MIP </strong></p>\n<p>(Mycobacterium indicus pranii)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Live vaccine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Killed vaccine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cannot be used in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can be used in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used for TB but also protects against leprosy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used as an <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> for <span class=\"customMeta\" data-dictid=\"f200a5b7181692777191c4f24b2a3e\">leprosy</span> <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> along with Rifampin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male patient presents with hypopigmented skin lesions (&amp;lt;5 in number) and numbness in her extremities. Examination reveals the presence of nerve thickening in the ulnar area. What is the duration of multidrug therapy in this patient?", "options": [{"label": "A", "text": "3 months", "correct": false}, {"label": "B", "text": "6 months", "correct": true}, {"label": "C", "text": "9 months", "correct": false}, {"label": "D", "text": "12 months", "correct": false}], "correct_answer": "B. 6 months", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:631px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CHARACTERISTIC</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PAUCIBACILLARY</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MULTIBACILLARY</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin lesions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-5 lesions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;5 lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nerve involvement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>≥1 nerve involved</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Slit skin smear</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Negative</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Positive</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:731px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dapsone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clofazimine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Paucibacillary (PB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adult</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>300 mg once a month &amp; 50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>600 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Child </strong></p>\n<p><strong>(9-14 yrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>150 mg once a month &amp; 50 mg <em>alternate day</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>450 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multibacillary (MB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adult</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>12 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>300 mg once a month &amp; 50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>600 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Child </strong></p>\n<p><strong>(9-14 yrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>12 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>150 mg once a month &amp; 50 mg<em> <span class=\"customMeta\" data-dictid=\"d65e6c0e1616927771818ab537250d\">alternate</span> day</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>450 mg once a month</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:922px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug-resistant <span class=\"customMeta\" data-dictid=\"f200a5b7181692777191c4f24b2a3e\">leprosy</span> Regimen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intensive Phase</strong> (6 months)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Continuation Phase </strong>(18 months)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin-resistant cases:</strong></p>\n<p>2 second line + 1 first line (Clofazimine)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n<p><strong>(or)</strong></p>\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + Clofazimine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n<p><strong>(or)</strong></p>\n<p>Ofloxacin + Clofazimine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin &amp; <span class=\"customMeta\" data-dictid=\"d78dc549171692777194a4af6724c2\">ofloxacin</span> resistant cases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clarithromycin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>(Clarithromycin or Minocycline) + Clofazimine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is contraindicated in patients with G6PD deficiency?", "options": [{"label": "A", "text": "Dapsone", "correct": true}, {"label": "B", "text": "Rifampin", "correct": false}, {"label": "C", "text": "Clarithromycin", "correct": false}, {"label": "D", "text": "Clofazimine", "correct": false}], "correct_answer": "A. Dapsone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:692px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dapsone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by inhibiting <span class=\"customMeta\" data-dictid=\"0bb5e4b870169277719411ef3a7206\">PABA</span> <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">incorporation</span> into <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> by <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> synthase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dapsone is bacteriostatic</li>\n<li>It undergoes <span class=\"customMeta\" data-dictid=\"9f7ab6e884169277718087212d98c0\">acetylation</span> and <span class=\"customMeta\" data-dictid=\"ed6dc0698216927771889e8a118c4f\">glucuronide</span> and <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">sulfate</span> <span class=\"customMeta\" data-dictid=\"5bf9387ee91692777185685e187e76\">conjugation</span> in the liver</li>\n<li>Excreted in the urine</li>\n<li>Plasma ½ life: &gt;24 hours</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>First-line for M.leprae</li>\n<li>Chloroquine-resistant malaria</li>\n<li>Toxoplasmosis prophylaxis</li>\n<li>Pneumocystis jirovecii infection prophylaxis</li>\n<li>Dermatitis herpetiformis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hemolytic <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> - <span class=\"customMeta\" data-dictid=\"c2b082746716927771888f0933941d\">Hemolysis</span> in patients with <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> (Antidote for <span class=\"customMeta\" data-dictid=\"d30ae941d516927771889351160b00\">hemolytic</span> anemia: <span class=\"customMeta\" data-dictid=\"f1f83adcbd1692777192944952fb13\">Methylene</span> Blue)</li>\n<li>Methaemoglobinaemia</li>\n<li>Paresthesias</li>\n<li>Neuropsychiatric symptoms</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old female patient presents to the dermatology clinic with multiple hypopigmented skin lesions and numbness in her extremities. A diagnosis is made after a thorough examination and testing. Which among the following drugs used to treat this condition is bacteriostatic?", "options": [{"label": "A", "text": "Ofloxacin", "correct": false}, {"label": "B", "text": "Moxifloxacin", "correct": false}, {"label": "C", "text": "Dapsone", "correct": true}, {"label": "D", "text": "Rifampin", "correct": false}], "correct_answer": "C. Dapsone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First-line drugs for leprosy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second-line drugs for leprosy</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rifampin-600 mg once a month (supervised)</li>\n<li>Dapsone-100 mg daily (unsupervised)</li>\n<li>Clofazimine (only in <span class=\"customMeta\" data-dictid=\"fcfe58b24e169277719388b41fd97f\">multibacillary</span> leprosy)\n\t\t\t\t<ul>\n<li>300mg once a month (supervised)</li>\n<li>50mg daily (unsupervised)</li>\n</ul>\n</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clarithromycin</li>\n</ul>\n<ul>\n<li>Ofloxacin, Moxifloxacin</li>\n</ul>\n<ul>\n<li>Minocycline</li>\n</ul>\n<ul>\n<li>Ethionamide</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Rifampicin and fluoroquinolones are bactericidal.</p>\n<p style=\"text-align:center\">All other <span class=\"customMeta\" data-dictid=\"f200a5b7181692777191c4f24b2a3e\">leprosy</span> drugs are bacteriostatic.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male with a history of advanced HIV/AIDS presents for a routine follow-up. His CD4 count is 50 cells/mm³, and he has been adherent to antiretroviral therapy for the past 6 months. Upon review of his medical history, it is noted that he had a previous episode of disseminated Mycobacterium avium complex (MAC) infection. Which of the following is the most appropriate prophylactic regimen for this patient?", "options": [{"label": "A", "text": "Ethambutol monotherapy", "correct": false}, {"label": "B", "text": "Clarithromycin monotherapy", "correct": false}, {"label": "C", "text": "Azithromycin monotherapy", "correct": true}, {"label": "D", "text": "Rifabutin plus azithromycin combination therapy", "correct": false}], "correct_answer": "C. Azithromycin monotherapy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old male with multidrug-resistant tuberculosis presents for initiation of treatment. Given his MDR-TB, the clinician decides to initiate oral bedaquiline therapy. Which of the following statements regarding oral bedaquiline therapy is true?", "options": [{"label": "A", "text": "Recommended in patients with fluoroquinolone resistance", "correct": false}, {"label": "B", "text": "Contraindicated with HIV co-infection", "correct": false}, {"label": "C", "text": "No risk of QT prolongation", "correct": false}, {"label": "D", "text": "Regular liver function tests required", "correct": true}], "correct_answer": "D. Regular liver function tests required", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:723px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>9-month-all oral <span class=\"customMeta\" data-dictid=\"d0a85225e8169277718252304cfc4b\">bedaquiline</span> therapy regimen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Medications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Duration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Phase:</strong></p>\n<p>Bedaquiline (6 months)<em> </em>+ Levofloxacin/Moxifloxacin + Ethionamide + Ethambutol + Isoniazid (high dose) + Pyrazinamide + Clofazimine<br/>\n<br/>\n\t\t\tAlternative for Ethionamide:<em> </em>Linezolid (2 months)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>4-6 months (extend to 6 months if <span class=\"customMeta\" data-dictid=\"5353537f861692777199e48431cd88\">sputum</span> <span class=\"customMeta\" data-dictid=\"6777533153169277719804fcbbf2d1\">smear</span> positive at 4 months)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Continuation Phase:</strong><strong> </strong></p>\n<p>Levofloxacin/Moxifloxacin + Clofazimine + Ethambutol + Pyrazinamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>5 months</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old patient presents with a history of pulmonary tuberculosis that has failed to respond to standard first-line treatment. Despite completing the initial course of therapy, the patient's symptoms have worsened, and sputum cultures confirm the presence of multidrug-resistant tuberculosis. Which of the following medications is most appropriate for managing this patient's condition?", "options": [{"label": "A", "text": "Bedaquiline", "correct": true}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Levofloxacin", "correct": false}, {"label": "D", "text": "Isoniazid", "correct": false}], "correct_answer": "A. Bedaquiline", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:730px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Monodrug resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MDR </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pre-XDR</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Isoniazid resistance: RZE+Levofloxacin for 8 months</li>\n<li>Rifampicin resistance: treat as <span class=\"customMeta\" data-dictid=\"3c0021ebec1692777192f766374e40\">MDR</span> TB</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is <span class=\"customMeta\" data-dictid=\"5d8c24b3cb16927771909a5195d7f8\">isoniazid</span> + <span class=\"customMeta\" data-dictid=\"6cd890fc7416927771978562618db8\">rifampicin</span> resistance</li>\n<li>BPaL-M is most preferred (Bedaquiline + pretomanid + <span class=\"customMeta\" data-dictid=\"fc8d5a958b169277719138b880fd95\">linezolid</span> + moxifloxacin) (Option A)</li>\n<li>All oral <span class=\"customMeta\" data-dictid=\"d0a85225e8169277718252304cfc4b\">bedaquiline</span> <span class=\"customMeta\" data-dictid=\"988bd8e7c71692777197b9f1d5d5ca\">regimen</span> is more commonly used throughout India</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is additoinal resistance to levefloxacin and moxifloxacin</li>\n<li>BPaL <span class=\"customMeta\" data-dictid=\"988bd8e7c71692777197b9f1d5d5ca\">regimen</span> is used if available</li>\n<li>All oral <span class=\"customMeta\" data-dictid=\"d0a85225e8169277718252304cfc4b\">bedaquiline</span> <span class=\"customMeta\" data-dictid=\"988bd8e7c71692777197b9f1d5d5ca\">regimen</span> used of BPaL are not available</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old patient diagnosed with multidrug-resistant tuberculosis (MDR-TB) is prescribed delamanid as part of the treatment regimen. The patient asks the physician how delamanid works to treat tuberculosis. Which of the following explanations best describes the mechanism of action of delamanid?", "options": [{"label": "A", "text": "Inhibits DNA gyrase and topoisomerase IV enzymes in bacteria", "correct": false}, {"label": "B", "text": "Inhibits mycolic acid synthesis in the cell wall of M.tuberculosis", "correct": true}, {"label": "C", "text": "Disrupts bacterial protein synthesis by binding to the 23S ribosomal RNA", "correct": false}, {"label": "D", "text": "Inhibits the synthesis of arabinogalactan in the cell wall of M.tuberculosis", "correct": false}], "correct_answer": "B. Inhibits mycolic acid synthesis in the cell wall of M.tuberculosis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:760px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Delamanid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of mycolic acid by <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> production, an essential component of the <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> of M.tuberculosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea, vomiting, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, headache, and elevated liver enzymes.</li>\n<li>QT prolongation, which can increase the risk of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias</li>\n<li>Monitoring of liver function and <span class=\"customMeta\" data-dictid=\"40ebcbf95e169277718613d7c2d999\">ECG</span> is recommended during treatment</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pretomanid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibiting the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of mycolic acid by disrupting the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids in the <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> of M.tuberculosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea, vomiting, and diarrhea</li>\n<li>Peripheral neuropathy</li>\n<li>Hepatotoxicity</li>\n<li>Acne</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Second-line ATT drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group C</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bedaquilin</li>\n<li>Levofloxacin or Moxifloxacin</li>\n<li>Linezolid</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cycloserine</li>\n<li>Clofazimine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Delamanid</li>\n<li>Amikacin</li>\n<li>Meropenem or Imipenem-cilastatin</li>\n<li>PAS</li>\n<li>Ethionamide</li>\n<li>Ethambutol</li>\n<li>Pyrazinamide</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old male with multidrug-resistant tuberculosis (MDR-TB) presents with generalised weakness, cold intolerance, weight gain despite reduced appetite, decreased libido, and difficulty maintaining erections. Lab tests show elevated liver enzymes and TSH. Which medication is likely causing these effects?", "options": [{"label": "A", "text": "Ethambutol can cause side effects such as optic neuritis (vision changes), rash, and gastrointestinal disturbances.", "correct": false}, {"label": "B", "text": "Isoniazid", "correct": false}, {"label": "C", "text": "Ethionamide", "correct": true}, {"label": "D", "text": "Levofloxacin", "correct": false}], "correct_answer": "C. Ethionamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false?", "options": [{"label": "A", "text": "Vitamin B6 is given to treat Cycloserine induced toxicity", "correct": false}, {"label": "B", "text": "Clofazimine causes urine discolouration", "correct": false}, {"label": "C", "text": "Cycloserine causes suicidal ideation", "correct": false}, {"label": "D", "text": "Clofazimine can cause constipation", "correct": true}], "correct_answer": "D. Clofazimine can cause constipation", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:901px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clofazimine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cycloserine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to bacterial DNA, inhibiting replication/transcription.</p>\n<p>It also has anti-inflammatory properties.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> <span class=\"customMeta\" data-dictid=\"7f4e6edbc91692777181c6fa295ae7\">alanine</span> racemase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>S/E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, diarrhea, discolouration of skin and body secretions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neurotoxicity (treated with Vitamin B6), dizziness, drowsiness, headache, confusion, psychosis, suicidal ideation, vomiting, diarrhea, and risk of seizures</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old woman with a history of cirrhosis presents to the clinic with fever, night sweats, and a persistent cough. After evaluation, she is diagnosed with pulmonary tuberculosis (TB). Given her liver disease, which of the following antitubercular drugs needs to be avoided?", "options": [{"label": "A", "text": "Streptomycin", "correct": false}, {"label": "B", "text": "Rifampin", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": true}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "C. Pyrazinamide", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:893px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name of drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Isoniazid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampin</strong><br/>\n<strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pyrazinamide</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ethambutol</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Streptomycin</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"89e2535e2416927771930505f8f408\">mycolic acids</span> (cell wall).</p>\n<p>It also inhibits <span class=\"customMeta\" data-dictid=\"e99dbef99f169277719344843cf75a\">mycobacterium</span> DHFR, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with <span class=\"customMeta\" data-dictid=\"6483f3ef3116927771935d328a8ab2\">nucleic acid</span> synthesis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Interrupts <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to mycobacterial DNA-dependent <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by getting converted into pyrazinoic acid</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in mycolic acid <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">incorporation</span> in the cell wall</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits 30S ribosomal protein synthesis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intramuscular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hepatotoxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cellularity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bactericidal/</strong><br/>\n<strong>Bacteriostatic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacteriostatic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacteria inhibited</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old HIV-positive male patient presents to the clinic reporting a recent contact with a sputum-positive TB patient. He has no active symptoms of TB. Which of the following is the recommended prophylactic regimen for TB in this patient?", "options": [{"label": "A", "text": "Isoniazid and pyrazinamide combination therapy", "correct": false}, {"label": "B", "text": "Isoniazid and ethambutol combination therapy", "correct": false}, {"label": "C", "text": "Isoniazid and streptomycin combination therapy", "correct": false}, {"label": "D", "text": "Isoniazid and rifapentine combination therapy", "correct": true}], "correct_answer": "D. Isoniazid and rifapentine combination therapy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient is newly diagnosed with TB and is found to be HIV positive. Which of the following ART drugs do not require dose-adjustment with Rifampin?", "options": [{"label": "A", "text": "Nevirapine", "correct": false}, {"label": "B", "text": "Dolutegravir", "correct": false}, {"label": "C", "text": "Ritonavir", "correct": false}, {"label": "D", "text": "Efavirenz", "correct": true}], "correct_answer": "D. Efavirenz", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is not used in TB patients with liver disease but is considered safe in renal disease?", "options": [{"label": "A", "text": "Streptomycin", "correct": false}, {"label": "B", "text": "Fluoroquinolone", "correct": false}, {"label": "C", "text": "Ethambutol", "correct": false}, {"label": "D", "text": "Rifampin", "correct": true}], "correct_answer": "D. Rifampin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:858px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>TB and liver disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>TB and <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>TB and pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>ATT drugs are hepatotoxic: <span class=\"customMeta\" data-dictid=\"34a5f1798516927771964e58d7a988\">Pyrazinamide</span> &gt; <span class=\"customMeta\" data-dictid=\"5d8c24b3cb16927771909a5195d7f8\">Isoniazid</span> &gt; Rifampicin</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Drug-induced liver injury</strong> <strong>(DILI):</strong></p>\n<ul>\n<li>Suspected when AST/ALT &gt; 5 times the upper limit of normal</li>\n<li>Stop ATT and start <strong>S</strong>treptomycin, <strong>L</strong>evofloxacin, and <strong>E</strong>thambutol</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safe drugs:</strong></p>\n<ul>\n<li>Rifampicin (excreted in bile)</li>\n<li>Isoniazid (excreted in bile)</li>\n<li>Pyrazinamide (excreted in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> but is considered safe)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Unsafe drugs:</strong></p>\n<ul>\n<li>Ethambutol (excreted by kidneys)</li>\n<li>Streptomycin (nephrotoxic)</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment:</strong></p>\n<ul>\n<li>Isoniazid + <span class=\"customMeta\" data-dictid=\"0a8c2e2c42169277719721608c50a4\">Rifampin</span> + <span class=\"customMeta\" data-dictid=\"34a5f1798516927771964e58d7a988\">Pyrazinamide</span> + Ethambutol + a high dose of Vitamin B6 (25-50 mg)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Drugs contraindicated:</strong></p>\n<ul>\n<li>Aminoglycosides</li>\n<li>Fluoroquinolones</li>\n<li>Ethionamide (C/I only in first <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> since it causes <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> anomalies)</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 56-year-old male patient with newly diagnosed pulmonary TB begins treatment with ATT. After several weeks of therapy, he complains of difficulty distinguishing colors and experiencing blurred vision. On examination, he exhibits decreased visual acuity and bilateral central scotomas. Which of the following drugs is responsible for this condition?", "options": [{"label": "A", "text": "Rifampin", "correct": false}, {"label": "B", "text": "Pyrazinamide", "correct": false}, {"label": "C", "text": "Streptomycin", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": true}], "correct_answer": "D. Ethambutol", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:712px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ethambutol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in arabinogalactan synthesis, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in cell wall</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mutation of embAB genes, which encodes the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> arabinosyl transferase, reducing its <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In the treatment of</p>\n<ul>\n<li>Mycobacterium tuberculosis</li>\n<li>Mycobacterium avium complex (MAC)</li>\n<li>Mycobacterium kansasii</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Painless loss of vision\n\t\t\t\t<ul>\n<li>Field defects due to <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis</li>\n<li>Loss of visual acuity</li>\n<li><strong>Red-green color blindness </strong>(Yellow vision- Digoxin; Blue vision- Sildenafil)</li>\n</ul>\n</li>\n<li>Nausea, rashes, fever</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is not used in the continuation phase of Drug susceptible TB treatment?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Rifampin", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": true}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "C. Pyrazinamide", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:444px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\"> </th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Pulmonary</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Extrapulmonary</strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Intensive phase </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isoniazid</p>\n<p>Rifampin</p>\n<p>Pyrazinamide</p>\n<p>Ethambutol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isoniazid</p>\n<p>Rifampin</p>\n<p>Pyrazinamide</p>\n<p>Ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For 2 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For 2 months</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Continuation phase </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isoniazid</p>\n<p>Rifampin</p>\n<p>Ethambutol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isoniazid</p>\n<p>Rifampin</p>\n<p>Ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For 4 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For 7-10 months</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male with pulmonary tuberculosis presents with acute pain and swelling in his right big toe after 6 weeks of antitubercular therapy. On examination, his right big toe is tender, erythematous, and warm to touch. Lab tests reveal elevated serum uric acid levels. Which of the following antitubercular drugs is most likely responsible for his current presentation?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Ethambutol", "correct": false}, {"label": "D", "text": "Pyrazinamide", "correct": true}], "correct_answer": "D. Pyrazinamide", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:702px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Pyrazinamide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Drug type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Prodrug</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Activation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Converted to pyrazinoic acid inside the bacterial cell by pyrazinamidase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Gene involved in activation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><em>pncA</em> gene encodes for pyrazinamidase, which converts <span class=\"customMeta\" data-dictid=\"34a5f1798516927771964e58d7a988\">pyrazinamide</span> into its active form</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Pyrazinoic acid accumulates in an <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> medium and likely inhibits mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by interacting with a different <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> than INH. It also disrupts the mycobacterial cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> and transport functions.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Resistance to <span class=\"customMeta\" data-dictid=\"34a5f1798516927771964e58d7a988\">pyrazinamide</span> develops rapidly if used alone and is mostly due to <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in the <em>pncA</em> gene</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Only to treat tuberculosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p>Most hepatotoxic</p>\n<p>Most potent at increasing <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid levels</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which rifamycin drug is specifically utilized in the treatment of hepatic encephalopathy?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Rifapentine", "correct": false}, {"label": "C", "text": "Rifabutin", "correct": false}, {"label": "D", "text": "Rifaximin", "correct": true}], "correct_answer": "D. Rifaximin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/B3zIBkMvogpSbHkogmeK1736483968.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:573px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin </strong><br/>\n<strong>(or Rifampin)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used in TB, leprosy</li>\n<li>Strong CYP inducer</li>\n<li>Food decreases absorption, so taken on an empty stomach</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifapentine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used for TB prophylaxis</li>\n<li>Strong CYP inducer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifabutin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used in MAC</li>\n<li>Less potent CYP inducer</li>\n<li>Side effects:\n\t\t\t\t<ul>\n<li><strong>Pseudo-jaundice</strong> (Orange discoloration of the skin)</li>\n<li>Panuveitis</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifaximin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is unabsorbable, so it is used to treat gut infections\n\t\t\t\t<ul>\n<li>Diarrhea predominant IBS, Traveller’s diarrhea</li>\n<li>To treat <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> encephalopathy</li>\n</ul>\n</li>\n<li>No effect on CYP</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with a history of atrial fibrillation is on warfarin therapy to prevent thromboembolic events. He is diagnosed with active pulmonary tuberculosis and started on antitubercular therapy. However, upon follow-up, his international normalized ratio (INR) is found to be subtherapeutic despite stable warfarin dosing. Which of the following antitubercular drugs is most likely responsible for the decreased efficacy of warfarin?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Ethambutol", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": false}, {"label": "D", "text": "Rifampicin", "correct": true}], "correct_answer": "D. Rifampicin", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old man presents with a persistent cough, fever, and night sweats for the past two weeks. He has a history of close contact with a family member diagnosed with active tuberculosis. A sputum sample is collected and tested using the Cartridge-Based Nucleic Acid Amplification Test (CBNAAT), which detects the genetic material of Mycobacterium tuberculosis and mutations associated with drug resistance. Which of the following antitubercular drugs is most likely to be affected based on this result?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Ethambutol", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": false}, {"label": "D", "text": "Rifampicin", "correct": true}], "correct_answer": "D. Rifampicin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/XlNSEs59qI8jw8vQkmUU1736483874.png", "https://image.prepladder.com/content/gyoxI8GpP6GILOH5zLPN1736483899.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a symptom of isoniazid toxicity?", "options": [{"label": "A", "text": "Hepatotoxicity", "correct": false}, {"label": "B", "text": "Systemic lupus erythematosus", "correct": false}, {"label": "C", "text": "Optic neuritis", "correct": false}, {"label": "D", "text": "Renal failure", "correct": true}], "correct_answer": "D. Renal failure", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old female patient with newly diagnosed TB is prescribed a regimen as part of her treatment plan. The healthcare provider emphasizes the importance of monitoring for neurotoxicity as a potential adverse effect associated with this therapy. What dose of Vitamin B6 is given to prevent neurotoxicity with the use of this drug?", "options": [{"label": "A", "text": "25-50 mg/day", "correct": false}, {"label": "B", "text": "200 mg/day", "correct": false}, {"label": "C", "text": "100 mg/day", "correct": false}, {"label": "D", "text": "10 mg/day", "correct": true}], "correct_answer": "D. 10 mg/day", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:834px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Neurotoxicity</strong></li>\n<li><strong>Hepatotoxicity</strong></li>\n<li><strong>Endocrine effects:</strong> <span class=\"customMeta\" data-dictid=\"c2bea3e6d316927771904c30803e44\">INH</span> induces CYP enzymes, potentially leading to <strong>gynaecomastia </strong>(in males) due to increased <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> production.</li>\n<li><strong>Other effects:</strong> Lethargy, mild <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> (sideroblastic), arthralgia, and rashes are also associated with <span class=\"customMeta\" data-dictid=\"c2bea3e6d316927771904c30803e44\">INH</span> use.</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>First-line drug for the treatment of active TB infection</li>\n<li>DOC for the treatment of <span class=\"customMeta\" data-dictid=\"cec2565ecd1692777191eed58869b2\">latent</span> TB infection</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs acts by inhibiting 1,3-beta-glucan synthase?", "options": [{"label": "A", "text": "Natamycin", "correct": false}, {"label": "B", "text": "Fluconazole", "correct": false}, {"label": "C", "text": "Caspofungin", "correct": true}, {"label": "D", "text": "Terbinafine", "correct": false}], "correct_answer": "C. Caspofungin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Natamycin<strong> </strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> in the fungal cell membrane, disrupting <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Terbinafine (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It inhibits <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> epoxidase, reduces <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> synthesis, and affects cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amphotericin B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to ergosterol, forming pores in the fungal cell membrane, leading to cell death.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluconazole, Itraconazole, <span class=\"customMeta\" data-dictid=\"03e69ce4341692777190edbcfbb900\">Ketoconazole</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> synthesis, affecting cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> function.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is NOT true regarding Amphotericin B?", "options": [{"label": "A", "text": "Acts by binding to ergosterol in fungal cell membranes.", "correct": false}, {"label": "B", "text": "Liposomal AMB is associated with lower nephrotoxicity than conventional AMB.", "correct": false}, {"label": "C", "text": "AMB is absorbed orally, making it suitable for treatment with systemic mycoses.", "correct": true}, {"label": "D", "text": "Drug of choice for the treatment of cryptococcal meningitis.", "correct": false}], "correct_answer": "C. AMB is absorbed orally, making it suitable for treatment with systemic mycoses.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:631px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amphotericin B</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> in fungal cell membranes <strong>(Option A)</strong>, forming pores that disrupt <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity, leading to leakage of <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> contents and fungal cell death.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preparation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Conventional <span class=\"customMeta\" data-dictid=\"2aca559df7169277718182de664e44\">Amphotericin B</span> (c-AMB)</li>\n<li>Amphotericin B <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> complex (ABLC)</li>\n<li>Liposomal <span class=\"customMeta\" data-dictid=\"2aca559df7169277718182de664e44\">Amphotericin B</span> (L-AMB)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cryptococcal meningitis<strong> (Option D)</strong>, mucormycosis, <span class=\"customMeta\" data-dictid=\"2e83427a461692777184438dd9af19\">coccidioidal</span> meningitis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nephrotoxicity: Most notable with conventional <span class=\"customMeta\" data-dictid=\"2aca559df7169277718182de664e44\">Amphotericin B</span> (c-AMB); less with liposomal formulations<strong> (Option B)</strong>.</li>\n<li>Fever, chills, and <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> can be managed with pre-treatment (NSAIDs, antihistamines).</li>\n<li>Anemia (requires <span class=\"customMeta\" data-dictid=\"ec50ec51401692777187009530441d\">erythropoietin</span> treatment).</li>\n<li>Renal <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> <span class=\"customMeta\" data-dictid=\"6caf3a39f416927771807e122b9032\">acidosis</span> leads to <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> imbalances (hypomagnesemia, hypokalemia).</li>\n<li>Arachnoiditis, when used intrathecally</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug belongs to the triazole group of antifungals known for its broad spectrum against yeast and moulds, including mucormycosis?", "options": [{"label": "A", "text": "Miconazole", "correct": false}, {"label": "B", "text": "Posaconazole", "correct": true}, {"label": "C", "text": "Clotrimaole", "correct": false}, {"label": "D", "text": "Ketoconazole", "correct": false}], "correct_answer": "B. Posaconazole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:497px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imidazoles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Triazoles</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Miconazole <strong>(Option A ruled out)</strong></li>\n<li>Clotrimazole <strong>(Option C ruled out)</strong></li>\n<li>Ketoconazole <strong>(Option D ruled out)</strong></li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Posaconazole <strong>(Option B)</strong></li>\n<li>Fluconazole</li>\n<li>Itraconazole</li>\n<li>Voriconazole</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posaconazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits fungal <span class=\"customMeta\" data-dictid=\"08a8798eef1692777199f2a6ba28f4\">sterol</span> 14α-demethylase, disrupting <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in fungal cell membranes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum of Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Broad spectrum against various fungi, including <span class=\"customMeta\" data-dictid=\"e3baadccd91692777182c9724090b3\">Aspergillus</span> spp., <span class=\"customMeta\" data-dictid=\"f54d5c5cf11692777183318f259e5f\">Candida</span> spp., and <span class=\"customMeta\" data-dictid=\"0b25ffa5ac1692777193a6c5d556ac\">Mucorales</span> (effective against mucormycosis).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common: Nausea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, diarrhoea, headache, dizziness.</p>\n<p>Rare: Anaemia, neutropenia, <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias, visual disturbances.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absorption of oral <span class=\"customMeta\" data-dictid=\"88f2ec11091692777199acf9e832c4\">suspension</span> is enhanced by low pH and <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> foods.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following azoles are primarily excreted through bile except?", "options": [{"label": "A", "text": "Ketoconazole", "correct": false}, {"label": "B", "text": "Itraconazole", "correct": false}, {"label": "C", "text": "Posaconazole", "correct": false}, {"label": "D", "text": "Fluconazole", "correct": true}], "correct_answer": "D. Fluconazole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:494px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Azole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose Adjustment in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Failure</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluconazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Renal (urine)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic (bile)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Itraconazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic (bile)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posaconazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic (bile, feces)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cpun1nWTuclC7nM5xjrW1748861151.mp3", "video": ""}, {"text": "A 65-year-old woman visits the dermatology clinic with a persistent and intensely itchy rash on her arms, legs, and trunk. She mentions that over-the-counter antihistamines have provided minimal relief. Which azole drug with antipruritic effects would be most suitable for managing her condition?", "options": [{"label": "A", "text": "Fluconazole", "correct": false}, {"label": "B", "text": "Ketoconazole", "correct": true}, {"label": "C", "text": "Itraconazole", "correct": false}, {"label": "D", "text": "Voriconazole", "correct": false}], "correct_answer": "B. Ketoconazole", "question_images": ["https://image.prepladder.com/content/uIdin7Q6yTKIrNtgMAiX1724222258.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following diseases with their respective drugs of choice: Diseases Drugs of Choice 1. Fungal Keratitis a. Natamycin 2. Seborrheic Dermatitis b. Ketoconazole 3. Mucormycosis c. Amphotericin B 4. Eumycetoma d. Itraconazole", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": true}, {"label": "B", "text": "1-c, 2-a, 3-d, 4-b", "correct": false}, {"label": "C", "text": "1-a, 2-b, 3-d, 4-c", "correct": false}, {"label": "D", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}], "correct_answer": "A. 1-a, 2-b, 3-c, 4-d", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:565px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preferred antifungals</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fungal Keratitis</strong><strong> </strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Natamycin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Disrupts fungal cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Seborrheic Dermatitis</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole (topical and oral)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits fungal <span class=\"customMeta\" data-dictid=\"29e8e2a5dd16927771855db589c581\">cytochrome</span> P450-dependent enzyme.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mucormycosis</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amphotericin B</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Disrupts fungal cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eumycetoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> Itraconazole </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> synthesis, essential for fungal membranes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Sporotrichosis</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Amphotericin B (Initiation)<br/>\n<br/>\n\t\t\tItraconazole (Maintainence)</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VOlTpRdtMWrdPgVcQs0i1746257594.mp3", "video": ""}, {"text": "A kidney transplant patient receiving cyclosporine develops a new fungal infection and is prescribed ketoconazole for treatment. What is the potential consequence of adding ketoconazole to the patient's regimen?", "options": [{"label": "A", "text": "Decreased effectiveness of cyclosporine", "correct": false}, {"label": "B", "text": "Elevated risk of toxicity with cyclosporine", "correct": true}, {"label": "C", "text": "No significant interaction between ketoconazole and cyclosporine", "correct": false}, {"label": "D", "text": "Enhanced elimination of cyclosporine", "correct": false}], "correct_answer": "B. Elevated risk of toxicity with cyclosporine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Impact on Cyclosporine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclosporine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Immunosuppressant; CYP3A4 substrate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrow <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> index; toxic if elevated</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP3A4 inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> → ↑ <span class=\"customMeta\" data-dictid=\"fa041055ec16927771858fe49c76d3\">cyclosporine</span> levels</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hepatic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity (boxed warning); can be severe or fatal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Endocrine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"c14fde32ad1692777199f3028a0682\">steroidogenesis</span> → ↓ cortisol/testosterone → gynecomastia, impotence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>GI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> discomfort</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pruritus, rash</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>QT Prolongation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of torsades <span class=\"customMeta\" data-dictid=\"233d458dd316927771854358419c86\">de</span> pointes when combined with other QT-prolonging drugs</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cyclosporine</strong><strong> </strong><strong> </strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole inhibits CYP3A4, increasing <span class=\"customMeta\" data-dictid=\"fa041055ec16927771858fe49c76d3\">cyclosporine</span> levels and potential <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> (nephrotoxicity, hepatotoxicity, neurotoxicity).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Warfarin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole inhibits <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> metabolism, increasing the risk of bleeding.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Statins (e.g., simvastatin, atorvastatin)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketoconazole increases <span class=\"customMeta\" data-dictid=\"389305b4521692777198497cf9c88b\">statin</span> levels, which can lead to an increased risk of statin-related adverse effects such as myopathy.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following antifungal drugs with their properties, uses, and specific adverse effects: 1.Fluconazole a. Preferred for Candida infections; Can cause QT prolongation 2.Itraconazole b. Preferred for Aspergillus infections; Can cause visual disturbances 3.Voriconazole c. Preferred for mucormycosis; Can cause hepatotoxicity 4.Posaconazole d. Preferred for prophylaxis in immunocompromised patients; Can cause gastrointestinal upset", "options": [{"label": "A", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}, {"label": "B", "text": "1-a, 2-c, 3-b, 4-d", "correct": false}, {"label": "C", "text": "1-b, 2-c, 3-a, 4-d", "correct": false}, {"label": "D", "text": "1-a, 2-d, 3-b, 4-c", "correct": true}], "correct_answer": "D. 1-a, 2-d, 3-b, 4-c", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:649px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluconazole</strong><strong> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Itraconazole</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Voriconazole </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posaconazole</strong></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits fungal <span class=\"customMeta\" data-dictid=\"29e8e2a5dd16927771855db589c581\">cytochrome</span> P450-dependent <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <span class=\"customMeta\" data-dictid=\"1ff7f443201692777191efc5e0efbd\">lanosterol</span> 14α-demethylase, leading to <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> synthesis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Well-absorbed orally.</li>\n<li>Metabolised by CYP2C19.</li>\n<li>Excreted in <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> except fluconazole.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Candida infections</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aspergillus infections</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mucormycosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prophylaxis in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>QT prolongation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visual disturbances</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gastrointestinal upset</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/J7wiZaWfJm2dTDNscNng1747763506.mp3", "video": ""}, {"text": "A 23-year-old man comes to the dermatology OPD. After examination, a diagnosis of onychomycosis was made, and he was started on oral terbinafine. What is the mechanism of action of this drug?", "options": [{"label": "A", "text": "Inhibition of thymidylate synthase", "correct": false}, {"label": "B", "text": "Inhibition of lanosterol 14-methylase", "correct": false}, {"label": "C", "text": "Inhibition of squalene epoxidase", "correct": true}, {"label": "D", "text": "Formation of pore in ergosterol membrane", "correct": false}], "correct_answer": "C. Inhibition of squalene epoxidase", "question_images": ["https://image.prepladder.com/content/AJSObs2TQfLjNtk15zyQ1724222299.png"], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Terbinafine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Competitive <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> epoxidase (Option C)</strong></p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Accumulation of <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> within fungal cells</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Inhibition of <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> synthesis</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Disruption of fungal cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Fungicidal action</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It has a high <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for <span class=\"customMeta\" data-dictid=\"add57598af169277719845e7c30916\">sebum</span> and thus accumulates in sebum, <span class=\"customMeta\" data-dictid=\"5435715e1b1692777199602bdc830a\">stratum</span> <span class=\"customMeta\" data-dictid=\"4c6845d8c91692777185b6503c306e\">corneum</span> and nails.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Topical: </strong>Used for treating <span class=\"customMeta\" data-dictid=\"dbb566df9216927772009e22e9d078\">tinea</span> infections (ringworm) and <span class=\"customMeta\" data-dictid=\"2918c7cf5716927771956553e7f2f3\">pityriasis</span> <span class=\"customMeta\" data-dictid=\"d8978d146e169277720159cb0f2631\">versicolor</span> (fungal skin infection).</li>\n</ul>\n<ul>\n<li><strong>Oral:</strong> <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for <span class=\"customMeta\" data-dictid=\"82f45100661692777194d0ca51d9e8\">onychomycosis</span> (fungal infection of the nails), <span class=\"customMeta\" data-dictid=\"dbb566df9216927772009e22e9d078\">tinea</span> capitis (scalp ringworm), and extensive fungal lesions.</li>\n</ul>\n<p>It is also used in oromucosal <span class=\"customMeta\" data-dictid=\"39ca145a0f1692777183a33d06e96d\">candidiasis</span> as an alternative to fluconazole.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Taste <span class=\"customMeta\" data-dictid=\"4586eccbe71692777186e577e31829\">disturbance</span> and rash; <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> application causes dryness, <span class=\"customMeta\" data-dictid=\"8f179d376f16927771905338bc9387\">itching</span> and irritation.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An 18-year-old high school student presents to the dermatology outpatient clinic with symptoms of tinea pedis and tinea capitis. The dermatologist opts for an antifungal agent that inhibits microtubules within fungal cells, thereby preventing mitosis. Which drug was most likely prescribed?", "options": [{"label": "A", "text": "Ciclopirox olamine", "correct": false}, {"label": "B", "text": "Griseofulvin", "correct": true}, {"label": "C", "text": "Nystatin", "correct": false}, {"label": "D", "text": "Caspofungin", "correct": false}], "correct_answer": "B. Griseofulvin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Griseofulvin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibition of microtubules within the fungal cells, thus inhibiting mitosis.</strong></p>\n<p>It results in the formation of multi-nucleated and stunted fungal hyphae.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Keratinophilic thus gets deposited in high concentration in <span class=\"customMeta\" data-dictid=\"5435715e1b1692777199602bdc830a\">Stratum</span> corneum, hair and nails</li>\n<li>Plasma <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> is 24 hours</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC in <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">Superficial</span> fungal infections such as Tinea.</p>\n<p>(T. capitis- most effective; T.curis , T.unguium, T.corporis- less effective; T. <span class=\"customMeta\" data-dictid=\"d8978d146e169277720159cb0f2631\">versicolor</span> – it is not effective)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Headache</li>\n<li>Neuritis</li>\n<li>Hepatitis</li>\n<li>Photosensitivity</li>\n<li>Disulfiram like reaction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old diabetic patient is admitted to the ICU with meningitis. He reported contact with pigeon droppings two weeks prior. India ink staining of his CSF sample confirmed Cryptococcus neoformans infection. What is the most appropriate drug combination for treating this fungal infection?", "options": [{"label": "A", "text": "Caspofungin + Flucytosine", "correct": false}, {"label": "B", "text": "Amphotericin B + Flucytosine", "correct": true}, {"label": "C", "text": "Voriconazole + Caspofungin", "correct": false}, {"label": "D", "text": "Amphotericin B + Posaconazole", "correct": false}], "correct_answer": "B. Amphotericin B + Flucytosine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:674px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amphotericin B</strong></p>\n<p>(Polyene <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">antibiotic</span> molecule)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Forms micropores in the <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> membrane.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cryptococcus neoformans</p>\n<p>Leishmania</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nephrotoxicity</p>\n<p>Allergic reaction</p>\n<p>Arachnoiditis</p>\n<p>Anemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Flucytosine</strong></p>\n<p>(pyrimidine antimetabolite)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibitor of <span class=\"customMeta\" data-dictid=\"e34386023d169277720036d8bccc88\">thymidylate</span> synthase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cryptococcus neoformans Chromoblastomyces.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dose-dependent <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</p>\n<p>Enteritis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following superficial fungal infection with the appropriate drug for treatment. FUNGAL INFECTION TOPICAL DRUG 1. Vulvo-vaginal candidiasis a. Griseofulvin 2. Tinea capitis b. Miconazole 3. Tinea versicolor c. Clotrimazole 4. Seborrheic dermatitis d. Ketoconazole", "options": [{"label": "A", "text": "1-c, 2-b, 3-d, 4-a", "correct": false}, {"label": "B", "text": "1-a, 2-c, 3-b, 4-d", "correct": false}, {"label": "C", "text": "1-c, 2-a, 3-b, 4-d", "correct": true}, {"label": "D", "text": "1-d, 2-b, 3-a, 4-c", "correct": false}], "correct_answer": "C. 1-c, 2-a, 3-b, 4-d", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:688px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Mechanism of action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Topical Uses</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Imidazole</p>\n<ul>\n<li>Oxiconazole</li>\n<li>Clotrimazole</li>\n<li>Miconazole</li>\n<li>Sertaconazole</li>\n<li>Ketoconazole</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p>Inhibition of <span class=\"customMeta\" data-dictid=\"1ff7f443201692777191efc5e0efbd\">lanosterol</span> 14-methylase</p>\n<br/>\n<br/>\n\t\t\t </td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Vulvovaginal <span class=\"customMeta\" data-dictid=\"39ca145a0f1692777183a33d06e96d\">candidiasis</span> (Clotrimazole)</strong></li>\n<li>Tinea infections</li>\n<li><strong>Tinea <span class=\"customMeta\" data-dictid=\"d8978d146e169277720159cb0f2631\">versicolor</span> (Miconazole)</strong></li>\n<li>Onychomycosis</li>\n<li><strong>Dandruff- <span class=\"customMeta\" data-dictid=\"5d5241c3cf1692777198a1ba71f8d4\">Seborrheic</span> <span class=\"customMeta\" data-dictid=\"fedc53b3161692777186553c8f8d7d\">dermatitis</span> caused by <span class=\"customMeta\" data-dictid=\"6111bb684c16927771911a53ba5b53\">Malassezia</span> furfur (ketoconazole)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triazole</p>\n<ul>\n<li>Fluconazole</li>\n<li>Itraconazole</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Griseofulvin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Inhibition of microtubules within the fungal cells, thus inhibiting mitosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cases covering large area </p>\n<p>Onychomycosis</p>\n<p><strong>Tinea capitis </strong></p>\n<p>Athletes foot </p>\n<p>Pityriasis <span class=\"customMeta\" data-dictid=\"d8978d146e169277720159cb0f2631\">versicolor</span> - not effective</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allylamine</p>\n<ul>\n<li>Terbinafine (topical and oral)</li>\n<li>Butenafine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitive <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> epoxidase results in <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> accumulation within the cells.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tinea infection and <span class=\"customMeta\" data-dictid=\"2918c7cf5716927771956553e7f2f3\">pityriasis</span> versicolor</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Other <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> agents: Ciclopirox olamine, Undecylenic acid, Benzoic acid</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following statements correctly describes nitroimidazoles? Metronidazole inhibits bacterial DNA synthesis by interacting directly with DNA. Metronidazole is a prodrug converted to its active form by the bacterial nitroreductase enzyme. Secnidazole is one of the shortest-acting nitroimidazoles. Metronidazole inhibits the PFOR enzyme, which damages DNA in protozoa. Resistance occurs through the activation of nitric oxide free radicals.", "options": [{"label": "A", "text": "1, 2 and 4", "correct": true}, {"label": "B", "text": "2 and 4", "correct": false}, {"label": "C", "text": "1, 2 and 3", "correct": false}, {"label": "D", "text": "1 and 3", "correct": false}], "correct_answer": "A. 1, 2 and 4", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:673px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nitroimidazoles</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prodrug is converted to active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> through <span class=\"customMeta\" data-dictid=\"bb349efe571692777193cd0d07baeb\">nitro</span> group reduction inside the bacteria<strong>(Statement 2) →</strong> formation of <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> free radicals → causes DNA damage→ inhibits replication<strong>(Statement 1) </strong></li>\n<li>Inhibits PFOR <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> (pyruvate <span class=\"customMeta\" data-dictid=\"91d0e4c6fa16927772025f96b44b27\">ferritin</span> oxido reductase) in <span class=\"customMeta\" data-dictid=\"b87627c189169277719689567ed39e\">protozoa</span> → causing DNA damage<strong>(Statement 4)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metronidazole</li>\n<li>Ornidazole</li>\n<li>Tinidazole</li>\n<li>Satranidazole</li>\n<li>Secnidazole: longest acting drug</li>\n<li>Other: Benznidazole, Nifurtimox, Nitazoxanide</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old man presents to the clinic with a history of abdominal pain and loose stools for the past two weeks but no h/o fever. He has recently returned from a vacation to Nepal. Physical examination reveals tenderness in the right lower quadrant of the abdomen. Stool testing shows mucoid stool with elevated white cell counts. What is the drug of choice for treating this condition?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Metronidazole", "correct": true}, {"label": "C", "text": "Albendazole", "correct": false}, {"label": "D", "text": "Doxycycline", "correct": false}], "correct_answer": "B. Metronidazole", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Metronidazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coverage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Broad spectrum anaerobes (Bacteroides, Clostridium, Fusobacterium, Peptococcus, etc.)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Giardiasis (in HIV-positive patients)</li>\n<li>Entamoeba histolytica → <span class=\"customMeta\" data-dictid=\"1b0f3628231692777181232735c06b\">Amebic dysentery</span> &amp; amebic liver abscess</li>\n<li>Trichomonas vaginalis</li>\n<li>Bacterial Vaginosis</li>\n<li>Dracunculus (guinea worm)</li>\n<li>Gardenella / bacterial vaginosis</li>\n<li>Empiric intra-abdomina and soft tissue <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections</li>\n<li>H. pylori <span class=\"customMeta\" data-dictid=\"7861e10657169277718815c2f42a75\">gastritis</span> (combined with <span class=\"customMeta\" data-dictid=\"9c823198d61692777196bc71097d6d\">proton</span> pump inhibitor)</li>\n<li>Prophylaxis for <span class=\"customMeta\" data-dictid=\"f04bf2125316927771847bfe139191\">colorectal</span> surgery</li>\n<li>Fulminant C.difficile infection (IV <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">metronidazole</span> + oral vancomycin)</li>\n<li>Mild to moderate Crohn's disease</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old man presented to the clinic with foul-smelling diarrhoea and abdominal cramps for the past week. A stool examination revealed giardia cysts. After starting appropriate treatment, she returned a few days later, complaining of severe nausea, vomiting, headaches, and flushing after the farewell party. Which of the following is not a side effect associated with the medication?", "options": [{"label": "A", "text": "Urine discolouration", "correct": false}, {"label": "B", "text": "Metallic taste", "correct": false}, {"label": "C", "text": "Peripheral neuropathy", "correct": false}, {"label": "D", "text": "Tendon rupture", "correct": true}], "correct_answer": "D. Tendon rupture", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:741px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse effects of Metronidazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metallic taste, intensely bitter <strong>(Option B)</strong></li>\n<li>Headache, nausea, <span class=\"customMeta\" data-dictid=\"e3afd7f63b1692777186b9a6e7824d\">dry mouth</span> (most common)</li>\n<li>Vomiting, diarrhoea, and <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> distress</li>\n<li>Dysuria, cystitis, and a sense of <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> pressure</li>\n<li>Dizziness, vertigo,</li>\n<li>Neurotoxicity: <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> neuropathy, numbness, paresthesias, <span class=\"customMeta\" data-dictid=\"0842a8a59f1692777182f44d334dda\">ataxia</span> <strong>(Option C)</strong></li>\n<li>Brown color <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> <strong>(Option A)</strong></li>\n<li>Urticaria, flushing, and <span class=\"customMeta\" data-dictid=\"c238cff71916927771965fb88e6cc4\">pruritus</span> ( rare cause of Stevens-Johnson syndrome)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drug Interaction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibitor of CYP enzymes</li>\n<li>Disulfiram-like effect: <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> distress, vomiting, flushing, headache or <span class=\"customMeta\" data-dictid=\"1cb2d1482916927771964c2890313e\">psychosis</span> with <span class=\"customMeta\" data-dictid=\"0751b802aa169277718100e38a1276\">alcoholic</span> beverages during or within 3 days of therapy.</li>\n<li>Precipitate <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> toxicity</li>\n<li>Prothrombin time prolongation with <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> (anticoagulant).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CNS diseases</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> disease</li>\n<li>First <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old HIV-positive male presents to the clinic with a two-week history of profuse, watery diarrhoea and weight loss. His CD4 count is 150 cells/mm³, and stool examination reveals oocysts. What is the drug of choice used for treating this patient's condition?", "options": [{"label": "A", "text": "Benznidazole", "correct": false}, {"label": "B", "text": "Nifurtimox", "correct": false}, {"label": "C", "text": "Nitazoxanide", "correct": true}, {"label": "D", "text": "Paromomycin", "correct": false}], "correct_answer": "C. Nitazoxanide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:553px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><em>Cryptosporidium parvum</em> (protozoan parasite)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Profuse watery diarrhoea, weight loss, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> cramps</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stool Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acid-fast oocysts</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CD4 count &lt;200 cells/mm³</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment of Choice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nitazoxanide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adjunctive Measures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ART initiation/improvement, hydration, nutritional support</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding bacterial resistance against nitroimidazoles?", "options": [{"label": "A", "text": "Increase efflux pump activity to remove nitroimidazoles from the cell.", "correct": false}, {"label": "B", "text": "Alter the structure of ribosomal subunits to prevent nitroimidazole binding.", "correct": false}, {"label": "C", "text": "Produce enzymes that inactivate nitroimidazoles before they can enter the cell.", "correct": false}, {"label": "D", "text": "Reduce the expression of nitroreductase enzymes needed to activate nitroimidazoles.", "correct": true}], "correct_answer": "D. Reduce the expression of nitroreductase enzymes needed to activate nitroimidazoles.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Resistance in Nitroimidazoles</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.</p>\n<p style=\"text-align:center\"><strong>Reduced nitroreductase <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> expression (Option D)</strong></p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Nitroimidazoles (such as metronidazole) cannot <span class=\"customMeta\" data-dictid=\"dddc752e1716927771807f985bb8bb\">activate</span> in their active form.</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">It prevents drug <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> and stops the formation of the <span class=\"customMeta\" data-dictid=\"092583d1b41692777197a506409267\">reactive</span> <span class=\"customMeta\" data-dictid=\"d1dd55acb8169277719302864e432d\">nitroso</span> group within the bacterial cell.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. <strong>Lower levels of PFOR and ferredoxin</strong>. (less common)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Rearrange the following steps in the correct sequence based on the mechanism of action of fluoroquinolones: 1. Inhibits DNA gyrase and topoisomerase IV. 2. DNA replication and transcription are hindered. 3. Bacterial cell division is disrupted. 4. Bacterial DNA supercoiling and strand separation are affected. 5. Bacterial cell death occurs.", "options": [{"label": "A", "text": "1, 4, 2, 3, 5", "correct": true}, {"label": "B", "text": "2, 4, 1, 3, 5", "correct": false}, {"label": "C", "text": "1, 2, 4, 3, 5", "correct": false}, {"label": "D", "text": "1, 4, 3, 2, 5", "correct": false}], "correct_answer": "A. 1, 4, 2, 3, 5", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KWzLgSNxB92I5Q18Q6Le1724322673.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Step</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Detail</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibition of <span class=\"customMeta\" data-dictid=\"27e761fe21169277718664069a016d\">DNA Gyrase</span> and <span class=\"customMeta\" data-dictid=\"f3fc0b88991692777200b39f3208ec\">Topoisomerase</span> IV</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fluoroquinolones specifically <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <strong>DNA gyrase</strong> and <strong>topoisomerase IV</strong>, which are critical for the maintenance of DNA structure. <strong>DNA gyrase</strong> alleviates DNA <strong>supercoiling</strong> ahead of the <span class=\"customMeta\" data-dictid=\"3e05409f651692777197645882d8a2\">replication</span> fork, while <strong>topoisomerase IV</strong> is involved in <strong>decatenation</strong>, which is the separation of replicated DNA.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Disruption of DNA Supercoiling and <span class=\"customMeta\" data-dictid=\"cf25c7ba04169277719946f465928b\">Strand</span> Separation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of these enzymes results in an accumulation of <strong>positive supercoils</strong> ahead of the <span class=\"customMeta\" data-dictid=\"3e05409f651692777197645882d8a2\">replication</span> fork and <strong>strand breaks</strong> in the DNA. This disrupts <span class=\"customMeta\" data-dictid=\"e700e82d9d169277718624870016ae\">DNA replication</span> and <strong>transcription</strong> processes by preventing the unwinding of DNA for these processes to occur.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hindrance of <span class=\"customMeta\" data-dictid=\"e700e82d9d169277718624870016ae\">DNA Replication</span> and Transcription</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>With disrupted <span class=\"customMeta\" data-dictid=\"e700e82d9d169277718624870016ae\">DNA replication</span> and transcription, bacterial cells cannot <span class=\"customMeta\" data-dictid=\"37ab4f3d3a16927771991ff7316442\">synthesize</span> new <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> or proteins, leading to a halt in growth and reproduction. Without proper DNA replication, the cell cannot reproduce, and without proper transcription, protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> is blocked.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Disruption of Bacterial Cell Division</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to the halted <span class=\"customMeta\" data-dictid=\"e700e82d9d169277718624870016ae\">DNA replication</span> and transcription, bacterial <strong>cell division</strong> is impaired. As bacteria need to replicate their DNA to divide, the inability to do so leads to <strong>cell cycle arrest</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacterial Cell Death</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The failure in <span class=\"customMeta\" data-dictid=\"3e05409f651692777197645882d8a2\">replication</span> and <span class=\"customMeta\" data-dictid=\"739aa4b5ea1692777200a636ee075f\">transcription</span> eventually causes <strong>bacterial cell death</strong> due to accumulated DNA damage and the inability to produce essential <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> components, including proteins.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/p76veWsfY3R7RWrfl00L1747296834.mp3", "video": ""}, {"text": "Which of the following statements about second-generation fluoroquinolones is false?", "options": [{"label": "A", "text": "They have a broader spectrum of activity compared to first-generation fluoroquinolones.", "correct": false}, {"label": "B", "text": "They inhibit bacterial DNA gyrase and topoisomerase IV.", "correct": false}, {"label": "C", "text": "They have a shorter half-life compared to first-generation fluoroquinolones.", "correct": true}, {"label": "D", "text": "They can cause QT prolongation as a side effect.", "correct": false}], "correct_answer": "C. They have a shorter half-life compared to first-generation fluoroquinolones.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:698px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>First Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Second Generation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n\t\t\t \n\n\t\t\t<p>Mnemonic: <strong>N</strong>ew<strong> COP</strong> has <strong>S</strong>mall <strong>L</strong>ite <strong>M</strong>achine <strong>G</strong>un</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Norfloxacin</li>\n<li>Ciprofloxacin</li>\n<li>Ofloxacin</li>\n<li>Pefloxacin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sparfloxacin</li>\n<li>Levofloxacin</li>\n<li>Moxifloxacin</li>\n<li>Gemifloxacin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pharmacokinetics</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Moderate half-life</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li><strong>Longer half-life(Option C is the false statement)</strong></li>\n<li>Better tissue penetration</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit bacterial DNA gyrase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"27e761fe21169277718664069a016d\">DNA gyrase</span> and <span class=\"customMeta\" data-dictid=\"f3fc0b88991692777200b39f3208ec\">topoisomerase</span> IV(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spectrum</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effective against <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> bacteria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Broader spectrum, including <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">Gram</span> (+ve), <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">Gram</span> (-ve) and <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">Atypical</span> pathogens.(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Prostatitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Respiratory infections (e.g.Pneumonia)</li>\n<li>Skin infections</li>\n<li>Complicated UTIs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Diarrhea</li>\n<li>Dizziness</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>QT prolongation(Option D)</strong></li>\n<li>Tendonitis</li>\n<li>CNS effects</li>\n<li>Phototoxicity</li>\n<li>Peripheral neuropathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pregnancy</li>\n<li>Children</li>\n<li>Myasthenia gravis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Same as first generation</li>\n<li>Patients with <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male presents with flu-like symptoms, including fever, malaise, and cough. Upon further questioning, he reports recent contact with animal hides during his work at a tannery. Chest X-ray revealed a widened mediastinum. Blood cultures are drawn, and the patient is to be started on antibiotics. Which of the following is the most appropriate treatment choice for this patient?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": true}, {"label": "B", "text": "Amoxicillin", "correct": false}, {"label": "C", "text": "Doxycycline", "correct": false}, {"label": "D", "text": "Vancomycin", "correct": false}], "correct_answer": "A. Ciprofloxacin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ciprofloxacin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Bioavailability ~70%,Moderate <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> (~4-5 hours)</li>\n<li>Widely distributed in tissues and body fluids</li>\n<li>Renal excretion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Prostatitis</li>\n<li>Pseudomonas aeruginosa (DOC)</li>\n<li><strong>Anthrax (Bacillus anthracis) (DOC)</strong></li>\n<li>Gastrointestinal infections (e.g., traveller's diarrhoea)</li>\n<li>Bone and joint infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastrointestinal disturbances (nausea, diarrhoea).</li>\n<li>CNS effects (headache, dizziness).</li>\n<li>Tendonitis and <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> rupture.</li>\n<li>Photosensitivity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pregnancy</li>\n<li>Children (due to potential for <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage)</li>\n<li>Myasthenia gravis (can exacerbate muscle weakness)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male presents to the emergency department with a 3-day history of productive cough, fever, and shortness of breath. Chest X-ray reveals consolidation in the right lower lobe consistent with community-acquired pneumonia. What is the most appropriate initial antibiotic therapy for this patient?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Azithromycin", "correct": false}, {"label": "C", "text": "Levofloxacin", "correct": true}, {"label": "D", "text": "Ceftriaxone", "correct": false}], "correct_answer": "C. Levofloxacin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Levofloxacin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Bioavailability ~99%</li>\n<li>Longer <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> (~6-8 hours)</li>\n<li>Widely distributed in tissues and body fluids</li>\n<li>Renal excretion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Community-acquired <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (DOC)</strong></li>\n<li>Acute bacterial sinusitis</li>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"ce5a7a84ff16927771830347fbbbff\">bronchitis</span> exacerbation</li>\n<li>Second-line drug for TB</li>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Prostatitis</li>\n<li>Skin and soft tissue infections</li>\n<li>Effective against <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> pathogens (e.g., Mycoplasma, Chlamydia, Legionella</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastrointestinal disturbances (nausea, diarrhoea)</li>\n<li>CNS effects (headache, dizziness)</li>\n<li>Tendonitis and <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">Tendon</span> rupture.</li>\n<li>QT interval prolongation</li>\n<li>Photosensitivity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pregnancy and lactation.</li>\n<li>Children and adolescents (due to potential for <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage)</li>\n<li>Myasthenia gravis (can exacerbate muscle weakness)</li>\n<li>Patients with a history of <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> disorders</li>\n<li>Cardiac arrhythmias (due to risk of QT prolongation)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the longest-acting fluoroquinolone?", "options": [{"label": "A", "text": "Sparfloxacin", "correct": true}, {"label": "B", "text": "Pefloxacin", "correct": false}, {"label": "C", "text": "Moxifloxacin", "correct": false}, {"label": "D", "text": "Delafloxacin", "correct": false}], "correct_answer": "A. Sparfloxacin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the side effects is not associated with fluoroquinolones?", "options": [{"label": "A", "text": "Tendon rupture", "correct": false}, {"label": "B", "text": "QT interval prolongation", "correct": false}, {"label": "C", "text": "Photosensitivity", "correct": false}, {"label": "D", "text": "Alopecia", "correct": true}], "correct_answer": "D. Alopecia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old female has been complaining of dysuria, increased frequency of urination, and mild lower abdominal discomfort for the past three days. She reports no fever, chills, or flank pain, and she has no known drug allergies. A urine dipstick test in the clinic shows positive nitrites and leukocyte esterase, indicating a possible mild, uncomplicated UTI. What is the most appropriate initial antibiotic treatment for this patient?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Ciprofloxacin", "correct": false}, {"label": "C", "text": "Nitrofurantoin", "correct": false}, {"label": "D", "text": "Cotrimoxazole", "correct": true}], "correct_answer": "D. Cotrimoxazole", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Cotrimoxazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitive <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">Inhibitor</span> of DHPS (PABA analogues)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trimethoprim-sulfamethoxazole (cotrimoxazole) ⟶ <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">Inhibit</span> <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">Dihydrofolate</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">Reductase</span> and Dihydropteroate <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">Synthase</span> ⟶ <span class=\"customMeta\" data-dictid=\"5744dac7511692777186db6f8e0c28\">Disruption</span> of <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">Folate</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of DNA, RNA, and Protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ Impaired Bacterial Cell Growth and Division ⟶ Accumulation of <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">Cellular</span> Damage ⟶ Bacterial Death.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (DOC for mild cases)</li>\n<li>Respiratory <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>GIT Infections</li>\n<li>Prevention and treatment of <span class=\"customMeta\" data-dictid=\"af71e1cffa16927771950a5fb2c281\">Pneumocystis</span> jirovecii <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Diarrhoea</li>\n<li>Rash</li>\n<li>Hypersensitivity reactions (including <span class=\"customMeta\" data-dictid=\"ed682ddaee16927771995530b7101b\">Stevens-Johnson syndrome</span> and toxic <span class=\"customMeta\" data-dictid=\"616d85c57416927771875ef23f6751\">epidermal</span> necrolysis)</li>\n<li>Blood dyscrasias (e.g., neutropenia, thrombocytopenia)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contraindicated in patients with <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> deficiency</li>\n<li>Use with caution in pregnant women, infants, and individuals with <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</li>\n<li>Increased risk of <span class=\"customMeta\" data-dictid=\"8bf09336411692777189d1a79bf6a5\">hyperkalemia</span> with potassium-sparing diuretics</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Choose the correct statements regarding nitrofurantoin: Is primarily used for the treatment of systemic infections. Works by damaging bacterial DNA and ribosomal proteins. Is well absorbed from the gastrointestinal tract and reaches high concentrations in urine. Is safe for use in patients with significant renal impairment.", "options": [{"label": "A", "text": "1 and 3", "correct": false}, {"label": "B", "text": "2 and 4", "correct": false}, {"label": "C", "text": "2 and 3", "correct": true}, {"label": "D", "text": "1 and 4", "correct": false}], "correct_answer": "C. 2 and 3", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:657px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nitrofurantoin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Urinary Antiseptic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Absorption:<strong> Rapidly absorbed </strong>from the GI tract<strong> (Food Increases Absorption)(Statement 3)</strong></li>\n<li><strong>Distribution: High concentration in urine(Statement 3)</strong></li>\n<li>Metabolism: Minimal <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> metabolism</li>\n<li><strong>Excretion: </strong>Excreted<strong> unchanged </strong>in urine<strong>, </strong>not recommended for use in patients with<strong> significant <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> (CrCl &lt; 60 mL/min).</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nitrofurantoin ⟶ <strong>Bacterial Reduction to <span class=\"customMeta\" data-dictid=\"092583d1b41692777197a506409267\">Reactive</span> Intermediates</strong> ⟶ Damage to Bacterial DNA and Ribosomal Proteins<strong>(Statement 2)</strong> ⟶ <span class=\"customMeta\" data-dictid=\"5744dac7511692777186db6f8e0c28\">Disruption</span> of DNA Replication, Transcription, and Translation ⟶ <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of Bacterial Cell Growth and Division ⟶ Bacterial Death</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Treatment of uncomplicated <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (UTIs)</strong></li>\n<li><strong>Prophylaxis for <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> UTIs</strong></li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Not effective for <span class=\"customMeta\" data-dictid=\"7d244db63c1692777196490682ecc8\">pyelonephritis</span> or prostatitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pulmonary reactions (acute and chronic)</li>\n<li>Brown Urine</li>\n<li>Hemolysis in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</li>\n<li>Hepatotoxicity</li>\n<li>Peripheral neuropathy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 23 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old male patient presents to the clinic with fatigue, jaundice, and abdominal discomfort. Laboratory tests reveal elevated liver enzymes and positive Hepatitis B surface antigen (HBsAg). Further evaluation shows HBsAg +ve, Anti- HBC IgG +ve, HBeAg +ve and evidence of liver inflammation on biopsy. What should be the drug of choice for the treatment of this patient?", "options": [{"label": "A", "text": "Lamivudine", "correct": false}, {"label": "B", "text": "Interferon-alpha", "correct": false}, {"label": "C", "text": "Tenofovir", "correct": true}, {"label": "D", "text": "Adefovir", "correct": false}], "correct_answer": "C. Tenofovir", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male patient with a history of hypertension and type 2 DM presents with significant shortness of breath, a persistent cough, and a high fever. His oxygen saturation is 85% on room air. After a thorough examination and necessary tests, he is diagnosed with COVID-19 pneumonia. Which of the following treatment measures has been shown to offer the maximum reduction in mortality for this patient?", "options": [{"label": "A", "text": "Hydroxychloroquine", "correct": false}, {"label": "B", "text": "Convalescent Plasma", "correct": false}, {"label": "C", "text": "Dexamethasone", "correct": true}, {"label": "D", "text": "Remdesivir", "correct": false}], "correct_answer": "C. Dexamethasone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Remdesevir (Option D)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Inhibits RNA-dependent <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Favipiravir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Molnupiravir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes errors in the <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> during replication</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nirmatrelvir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Protease inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bebtelovimab</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Monoclonal antibodies against <span class=\"customMeta\" data-dictid=\"1931730fd41692777199bf164f574c\">spike</span> protein of SARS-CoV2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bamlanivimab</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sotrovimab</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tocilizumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IL-6 inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Baricitinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Janus <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Corticosteroids</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Methylprednisolone/dexamethasone.</p>\n<p>Reduction of mortality and inflammation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heparin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-coagulation and prevention of thrombotic complications.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is generally not used for topical HSV infections?", "options": [{"label": "A", "text": "Acyclovir", "correct": false}, {"label": "B", "text": "Trifluridine", "correct": false}, {"label": "C", "text": "Ganciclovir", "correct": true}, {"label": "D", "text": "Docosanol", "correct": false}], "correct_answer": "C. Ganciclovir", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nucleoside analogues</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong>idarabine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Viral <span class=\"customMeta\" data-dictid=\"59b270e4eb1692777186cf05589eda\">DNA polymerase</span> Inhibition.</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Topical treatment of <span class=\"customMeta\" data-dictid=\"17df0c44e116927771897deca1bbf4\">HSV</span> infections</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong>doxuridine</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by competing with <span class=\"customMeta\" data-dictid=\"e32083bfa81692777200f1407487aa\">thymidine</span> triphosphate.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trifluridine (OptionB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Herpes simplex keratitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acyclovir (DOC) (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Viral <span class=\"customMeta\" data-dictid=\"59b270e4eb1692777186cf05589eda\">DNA polymerase</span> Inhibition.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Genital herpes, cold sores (HSV-1, HSV-2)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>idofovir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Viral <span class=\"customMeta\" data-dictid=\"59b270e4eb1692777186cf05589eda\">DNA polymerase</span> Inhibition.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Off-label <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> use for certain <span class=\"customMeta\" data-dictid=\"17df0c44e116927771897deca1bbf4\">HSV</span> infections</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcohol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Docosanol (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> between the <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> and the <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> simplex virus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cold sores (HSV-1)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Choose the correct statements regarding cidofovir. 1. It is primarily used in the treatment of CMV retinitis. 2. It can be administered orally. 3. It is commonly used as a first-line treatment for influenza infections. 4. Requires probenecid co-administration.", "options": [{"label": "A", "text": "1 and 4", "correct": true}, {"label": "B", "text": "2 and 3", "correct": false}, {"label": "C", "text": "1 and 2", "correct": false}, {"label": "D", "text": "1 and 3", "correct": false}], "correct_answer": "A. 1 and 4", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid\">\n<p style=\"text-align:center\"><strong>Cidofovir</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid\">\n<p>It is a <span class=\"customMeta\" data-dictid=\"8dcffccac016927771927605248b59\">monophosphate</span> <span class=\"customMeta\" data-dictid=\"94a2f0970016927771932885a3d362\">nucleotide</span> <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> of cytidine.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li><strong>Administered intravenously (Statement 2- Ruled Out)</strong></li>\n<li>Excreted unchanged by kidneys</li>\n<li>A long <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> allows for once-weekly dosing</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Penetrates into infected cells ⟶ Converted to active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> ⟶ <strong>Inhibits</strong> <strong>viral</strong> <strong>DNA</strong> <strong>polymerase</strong> ⟶ <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">Incorporation</span> into <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA ⟶ Terminates DNA chain elongation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li><strong>Treatment of <span class=\"customMeta\" data-dictid=\"ee831318721692777185479e65655e\">cytomegalovirus</span> (CMV) <span class=\"customMeta\" data-dictid=\"4f1a033cae1692777197a3a6937a0c\">retinitis</span> in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients (Statement 1).</strong></li>\n<li>Off-label use in treating other <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> infections, such as adenovirus, herpesviruses (HSV, VZV), and <span class=\"customMeta\" data-dictid=\"70ae0d8a1f1692777194515e8836a4\">papillomavirus</span> infections <strong>(Statement 3- Ruled Out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li><strong>Nephrotoxicity (Administer with <span class=\"customMeta\" data-dictid=\"2ee374b25c16927771963eae834a26\">Probenecid</span> to reduce toxicity) (Statement 4).</strong></li>\n<li>Neutropenia.</li>\n<li>Hypotension.</li>\n<li>Ocular effects (including <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> and iritis).</li>\n<li>Gastrointestinal disturbances (nausea, diarrhoea).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with a history of HIV infection presents to the clinic with complaints of blurred vision, floaters, and pain in his left eye. On fundus examination, following appearance is seen. Which of the following drugs is most appropriate to manage this condition?", "options": [{"label": "A", "text": "Acyclovir", "correct": false}, {"label": "B", "text": "Valganciclovir", "correct": true}, {"label": "C", "text": "Oseltamivir", "correct": false}, {"label": "D", "text": "Ribavirin", "correct": false}], "correct_answer": "B. Valganciclovir", "question_images": ["https://image.prepladder.com/content/qLwcelOJRunDdFIuoIrr1736482910.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Valganciclovir</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nucleoside analogue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oral administration.</li>\n<li>Converted to <span class=\"customMeta\" data-dictid=\"c6784934931692777188d5bd75988f\">ganciclovir</span> (Prodrug).</li>\n<li>Renal clearance.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Conversion to <span class=\"customMeta\" data-dictid=\"c6784934931692777188d5bd75988f\">Ganciclovir</span> ⟶ <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">Incorporation</span> into <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> DNA ⟶ <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> <span class=\"customMeta\" data-dictid=\"59b270e4eb1692777186cf05589eda\">DNA Polymerase</span> ⟶ Prevention of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ Decreased <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> Replication</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CMV retinitis</li>\n<li>CMV <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> in transplant patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Neutropenia</li>\n<li>Thrombocytopenia</li>\n<li>Anemia</li>\n<li>Fever</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents with painful vesicular lesions on his lips and genital area. He has been on acyclovir therapy for HSV infection, but there has been no improvement in his symptoms. Given the concern for acyclovir-resistant HSV, which of the following drugs is most appropriate to manage this condition?", "options": [{"label": "A", "text": "Valacyclovir", "correct": false}, {"label": "B", "text": "Famciclovir", "correct": false}, {"label": "C", "text": "Foscarnet", "correct": true}, {"label": "D", "text": "Oseltamivir", "correct": false}], "correct_answer": "C. Foscarnet", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:645px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Foscarnet</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cidofovir</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiviral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiviral</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>IV administration</li>\n<li>Renal clearance</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>IV administration</li>\n<li>Renal clearance</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits<strong> <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"59b270e4eb1692777186cf05589eda\">DNA polymerase</span> </strong>directly</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA polymerase</li>\n<li>Incorporates into <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>HSV infections resistant to acyclovir</li>\n<li>CMV retinitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acyclovir-resistant <span class=\"customMeta\" data-dictid=\"17df0c44e116927771897deca1bbf4\">HSV</span> infections</li>\n<li>CMV retinitis</li>\n<li>Respiratory papillomatosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nephrotoxicity</li>\n<li>Electrolyte imbalances</li>\n<li>Seizures</li>\n<li>Anemia</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nephrotoxicity</li>\n<li>Ocular hypotony</li>\n<li>Neutropenia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old male presents to the physician with painful ulcers and a burning sensation over his genital area. Physical examination reveals a fluid-filled vesicular lesion with a red erythematous base (image). All of the following are true regarding the drug of choice (DOC) for this condition, except?", "options": [{"label": "A", "text": "It is an antiviral drug that works as a nucleotide analogue, preventing viral replication.", "correct": true}, {"label": "B", "text": "It is applied topically, intravenously, or orally.", "correct": false}, {"label": "C", "text": "It should be taken with plenty of water.", "correct": false}, {"label": "D", "text": "It is also used to treat Ebstein Barr virus (EBV) and varicella-zoster virus (VZV)", "correct": false}], "correct_answer": "A. It is an antiviral drug that works as a nucleotide analogue, preventing viral replication.", "question_images": ["https://image.prepladder.com/content/Fu8cu4FgMlsvEhUo1Pxa1736482798.png"], "explanation_images": ["https://image.prepladder.com/content/eTRfCMYkqI3ZTgLkvNIF1736482853.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old woman arrives at the clinic with a high-grade fever, myalgia, and a dry cough that has persisted for the last 36 hours. Her family doctor diagnosed her with a flu infection and recommended baloxavir. Which of the following correctly describes the drug's mechanism of action?", "options": [{"label": "A", "text": "Inhibits neuraminidase, preventing the release of new viral particles", "correct": false}, {"label": "B", "text": "Inhibits viral RNA polymerase, preventing viral replication", "correct": true}, {"label": "C", "text": "Inhibits M2 ion channels, preventing viral uncoating", "correct": false}, {"label": "D", "text": "Inhibits viral protease, preventing viral maturation", "correct": false}], "correct_answer": "B. Inhibits viral RNA polymerase, preventing viral replication", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Target/Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Virus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Baloxavir</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"d419920a6616927771969805c3d65d\">polymerase</span> (endonuclease activity)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Influenza A &amp; B</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oseltamivir/Zanamivir</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"257d9cb9fb1692777193840b7918f6\">neuraminidase</span> → prevents <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> release</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Influenza A &amp; B</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amantadine/Rimantadine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits M2 <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> channel → blocks uncoating</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Influenza A only</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protease Inhibitors (e.g. Ritonavir)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> → prevent maturation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HIV, HCV</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/as81UhM1vbnSY3akxrJi1747294807.mp3", "video": ""}, {"text": "A 23-year-old male presents to the hospital with a high-grade fever, chest pain and dry cough for the last two days. A rapid influenza test confirmed the diagnosis. Which of the following is the treatment of choice for this patient's condition?", "options": [{"label": "A", "text": "Reassurance", "correct": false}, {"label": "B", "text": "Oseltamivir", "correct": true}, {"label": "C", "text": "Amantidine", "correct": false}, {"label": "D", "text": "Zanamivir", "correct": false}], "correct_answer": "B. Oseltamivir", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"8\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Management of <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">Influenza</span> (flu virus)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>M-Protein inhibitors</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neuraminidase inhibitors</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">Blocks protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and <span class=\"customMeta\" data-dictid=\"3a8a6dc85b1692777202f2db609ebb\">virion</span> assembly</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> release</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drug and Uses</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <strong>Amantadine (Option C)</strong></p>\n<ul>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">influenza</span> + parkinsons disease</li>\n</ul>\n<p>2. Rimantidine</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Oseltamavir (Tamiflu)</p>\n<ul>\n<li>Oral</li>\n<li>DOC: <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">Influenza</span> A and B</li>\n</ul>\n<p>2. <strong>Zanamavir (Option D):</strong></p>\n<ul>\n<li>Inhalational</li>\n<li>DOC: Resistant <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">influenza</span> A and B</li>\n<li>C/I in <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> and COPD</li>\n</ul>\n<p>3. IV Peramavir</p>\n<p>4. Lanimavir</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>High resistance</li>\n<li>Ankle oedema</li>\n<li>Livedo reticularis</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea/vomiting</li>\n<li>Bronchospasm (zanamavir)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-year-old child presents to the hospital with persistent cough, wheezing, and difficulty breathing. A viral panel is conducted, and the child is diagnosed with respiratory syncytial virus (RSV). What is the drug of choice for this condition?", "options": [{"label": "A", "text": "Lenecapavir", "correct": false}, {"label": "B", "text": "Ribavirin", "correct": true}, {"label": "C", "text": "Interferon-alpha", "correct": false}, {"label": "D", "text": "Palivizumab", "correct": false}], "correct_answer": "B. Ribavirin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 47-year-old female with chronic hepatitis C, who is currently on sofosbuvir, presents with a persistent cough, weight loss, and fever. Chest X-ray revealed a cavitatory lesion with hilar lymphadenopathy in the right lower lobe. The patient was started on an appropriate treatment regimen. Which of the following complications is likely to be seen in this case?", "options": [{"label": "A", "text": "Decreased efficacy of sofosbuvir", "correct": true}, {"label": "B", "text": "Increased risk of hepatotoxicity", "correct": false}, {"label": "C", "text": "Increased risk of peripheral neuropathy", "correct": false}, {"label": "D", "text": "Increased risk of fatal cardiac arrest", "correct": false}], "correct_answer": "A. Decreased efficacy of sofosbuvir", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 38-year-old man with a history of drug abuse presents to the clinic with jaundice and right upper quadrant pain. Laboratory tests confirm the presence of anti-HCV antibodies. The gastroenterologist advises starting NS5A and NS5B inhibitor combination therapy. Which of the following correctly describes the mechanism of action of the drugs used in this patient? Inhibits viral protease, preventing the cleavage of viral polyproteins Inhibits viral RNA polymerase, halting viral RNA synthesis Inhibits the viral protein essential for viral RNA replication and assembly Inhibits viral exit through degradation of viral RNA", "options": [{"label": "A", "text": "1 and 2", "correct": false}, {"label": "B", "text": "2 and 3", "correct": true}, {"label": "C", "text": "3 and 4", "correct": false}, {"label": "D", "text": "1 and 3", "correct": false}], "correct_answer": "B. 2 and 3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Management of Hepatitis C</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Directly acting antivirals (DAA): Drug of choice</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Interferon alpha</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>NS3/4A Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>NS5A Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>NS5B Inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Functions as a <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitor, cleave functional protein</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"3e05409f651692777197645882d8a2\">replication</span> and assembly</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>RNA <span class=\"customMeta\" data-dictid=\"d419920a6616927771969805c3d65d\">polymerase</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Produce <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> RNA degrading <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> and inhibits exit of the virus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ends with -previr-<br/>\n\t\t\t </p>\n<p>1. Simeprevir</p>\n<p>2. Boceprevir</p>\n<p>3. Voxilaprevir</p>\n<p>4. Telaprevir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ends with -Asvir-<br/>\n\t\t\t </p>\n<p>1. Ledipasvir</p>\n<p>2. Ombitasvir</p>\n<p>3. <strong>Velpatasvir</strong></p>\n<p>4. Elbasvir</p>\n<p>5. Daclatasvir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ends with -bruvir-</p>\n\t\t\t \n\n\t\t\t<p>1. Dasabuvir</p>\n<p><strong>2. Sofosbuvir</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pegylated <span class=\"customMeta\" data-dictid=\"e25285958816927771903175f9633f\">interferon</span> α</p>\n<ul>\n<li>Used in Hepatitis C, B and D</li>\n<li>DOC for Hepatitis B &amp; D coinfection</li>\n<li>Kaposi Sarcoma</li>\n<li>CML</li>\n<li>Hepatitis <span class=\"customMeta\" data-dictid=\"f3063c1d8b169277719018bf869980\">induced</span> thrombocytopenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adverse events</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Avoid use with <span class=\"customMeta\" data-dictid=\"e4bcd9fe2c1692777187df0dbb0ddc\">ethinyl</span> <span class=\"customMeta\" data-dictid=\"d8cc09346f16927771878d48ba1ce8\">estradiol</span> (hepatotoxicity)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Avoid with antacids and potent P-gp inducers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Avoid use with amiodarone (severe bradycardia)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. BM suppression</p>\n<p>2. Hypo/ hyperthyroidism</p>\n<p>3. Flu-like syndrome</p>\n<p>4. Nephrotoxicity</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old man presents to the clinic with persistent fatigue, weight loss, and recurrent infections. After testing, he is diagnosed with HIV. The physician discusses initiating antiretroviral therapy (ART) with drugs that inhibit nucleoside reverse transcriptase enzyme. Which of the following drugs does not belong to that class?", "options": [{"label": "A", "text": "Abacavir.", "correct": false}, {"label": "B", "text": "Tenofovir.", "correct": true}, {"label": "C", "text": "Stavudine.", "correct": false}, {"label": "D", "text": "Didanosine.", "correct": false}], "correct_answer": "B. Tenofovir.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:688px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nucleoside <span class=\"customMeta\" data-dictid=\"2c764fcf7316927771978d26033b04\">reverse transcriptase</span> inhibitors (NRTIs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Requires phosphorylation</strong> to convert into fake active nucleotides</li>\n<li>Competitive <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"2c764fcf7316927771978d26033b04\">reverse transcriptase</span> (RNA-dependent DNA polymerase) enzyme</li>\n<li>Incorporated into the <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA chain during replication, leading to chain termination</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Active against HIV1 and HIV2</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pharmacokinetics</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>All excreted by the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> except <strong>Zidovudine</strong> and <strong>Abacavir</strong></li>\n<li>Metabolised by non-microsomal enzymes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: <strong>DAZZELS</strong></p>\n<ul>\n<li>D - Didanosine <strong>(Option D ruled out)</strong></li>\n<li>A - Abacavir <strong>(Option A ruled out)</strong></li>\n<li>Z - Zidovudine</li>\n<li>Z - Zalcitabine</li>\n<li>E - Emtricitabine </li>\n<li>L - Lamivudine </li>\n<li>S - Stavudine <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male patient who is HIV-positive presents with a persistent cough, night sweats, weight loss, and fever. Sputum samples confirm the diagnosis of tuberculosis. His CD4 count is 150 cells/mm³, and he is not currently on antiretroviral therapy. What should be the next step in the management of this patient?", "options": [{"label": "A", "text": "Start antiretroviral therapy (ART) immediately", "correct": false}, {"label": "B", "text": "Initiate anti-tuberculosis treatment first and defer ART", "correct": true}, {"label": "C", "text": "Start both anti-tuberculosis treatment and ART simultaneously", "correct": false}, {"label": "D", "text": "Administer prophylactic treatment for opportunistic infections before starting any TB or HIV treatment", "correct": false}], "correct_answer": "B. Initiate anti-tuberculosis treatment first and defer ART", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An intern presents to the occupational health department after sustaining a needle stick injury from a suspected HIV-positive patient. In this case, what is the regimen of choice for post-exposure prophylaxis (PEP)?", "options": [{"label": "A", "text": "Zidovudine + Lamivudine + Ritonavir", "correct": false}, {"label": "B", "text": "Emtricitabine + Tenofovir + Atazanavir", "correct": false}, {"label": "C", "text": "Tenofovir + Emtricitabine + Raltegravir", "correct": false}, {"label": "D", "text": "Tenofovir + Lamivudine + Dolutegravir", "correct": true}], "correct_answer": "D. Tenofovir + Lamivudine + Dolutegravir", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/45AiXFQ62hqtlOpooGGd1746257726.mp3", "video": ""}, {"text": "A 30-year-old patient presents to the clinic with symptoms suggestive of HIV infection. Upon testing, the diagnosis of HIV is confirmed. What is the regimen of choice for initiating antiretroviral therapy for this patient?", "options": [{"label": "A", "text": "Abacavir + Lamivudine + Dolutegravir.", "correct": false}, {"label": "B", "text": "Tenofovir + Lamivudine + Efavirenz.", "correct": false}, {"label": "C", "text": "Tenofovir + Lamivudine + Dolutegravir.", "correct": true}, {"label": "D", "text": "Abacavir + Lamivudine + Lopinavir.", "correct": false}], "correct_answer": "C. Tenofovir + Lamivudine + Dolutegravir.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QuNhOQfOg1mb1qallbMO1747294922.mp3", "video": ""}, {"text": "Which of the following is a CCR5 inhibitor used in the treatment of HIV?", "options": [{"label": "A", "text": "Enfuvirtide", "correct": false}, {"label": "B", "text": "Fostemsavir", "correct": false}, {"label": "C", "text": "Ibalizumab", "correct": false}, {"label": "D", "text": "Maraviroc", "correct": true}], "correct_answer": "D. Maraviroc", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Entry Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Block the <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> virus from entering the host cell.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CCR5 <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">Inhibitor</span> (<strong>Maraviroc</strong>)</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bind to the CCR5 co-receptor on the host cell membrane.</p>\n<p>Only <span class=\"customMeta\" data-dictid=\"ccd357daaf16927771825777ea6a0d\">attachment</span> inhibitors active against both <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> 1&amp;2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fusion Inhibitors (<strong>Enfuvirtide</strong>)</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prevent the <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> of the <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> virus with the host cell membrane.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Attachment Inhibitors</strong></p>\n<p><strong>(Fostemsavir)</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bind to the gp120 subunit of the <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> envelope, preventing <span class=\"customMeta\" data-dictid=\"ccd357daaf16927771825777ea6a0d\">attachment</span> to the CD4 receptor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post-Attachment Inhibitors</strong></p>\n<p><strong>(Ibalizumab)</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bind to CD4 receptors, preventing conformational changes needed for <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> entry.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old patient with HIV is being treated with darunavir as part of their antiretroviral therapy. To enhance the effectiveness of darunavir, the physician adds another medication. Which of the following drugs can be used for this purpose?", "options": [{"label": "A", "text": "Atazanavir", "correct": false}, {"label": "B", "text": "Efavirenz", "correct": false}, {"label": "C", "text": "Cobicistat", "correct": true}, {"label": "D", "text": "Lamivudine", "correct": false}], "correct_answer": "C. Cobicistat", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old patient on anti-HIV therapy presents to the emergency department with complaints of severe flank pain, nausea, and vomiting. Laboratory tests reveal hematuria, and a CT scan shows evidence of nephrolithiasis. Which of the following protease inhibitors is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Indinavir", "correct": true}, {"label": "B", "text": "Ritonavir", "correct": false}, {"label": "C", "text": "Atazanavir", "correct": false}, {"label": "D", "text": "Darunavir", "correct": false}], "correct_answer": "A. Indinavir", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ritonavir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastrointestinal disturbances.</li>\n<li>Hyperlipidemia.</li>\n<li>Hepatotoxicity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atazanavir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Indirect <span class=\"customMeta\" data-dictid=\"cab274fa4f1692777189f9b6dad514\">hyperbilirubinemia</span> (jaundice).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Darunavir</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rash.</li>\n<li>Liver function abnormalities.</li>\n<li>Gastrointestinal disturbances.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding the properties of protease inhibitors are true? Nelfinavir is an aspartyl protease inhibitor that prevents viral protein assembly in the cell. Lipodystrophy is a common side effect seen with the majority of protease inhibitors. Ritonavir boosts plasma levels of lopinavir by inhibiting the CYP2C9 enzyme. Ritonavir is associated with a higher risk of intracranial haemorrhage. Cross-resistance among other protease inhibitors is rare.", "options": [{"label": "A", "text": "Statements 1 and 3 are correct.", "correct": false}, {"label": "B", "text": "Statements 1 and 2 are correct.", "correct": true}, {"label": "C", "text": "Statements 1, 3, and 4 are correct.", "correct": false}, {"label": "D", "text": "All statements are correct", "correct": false}], "correct_answer": "B. Statements 1 and 2 are correct.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Protease inhibitors (PI): (-navir-)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits the assembly/packaging of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> proteins</li>\n<li>Competitively inhibits the action of <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> <span class=\"customMeta\" data-dictid=\"d8b501495a16927771829f9857080b\">aspartyl</span> protease</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pharmacokinetics</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All are CYP3A4 inhibitors: Except Nelfinavir (CYP2C9)</p>\n<ul>\n<li>Increases <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> of other drugs</li>\n<li>Simvastatin: Risk of myopathy</li>\n<li>Midazolam: Causes <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HIV treatment and 2nd line Post-exposure prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs: <strong>RAFT ISLAND</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ritonavir\n\t\t\t\t<ul>\n<li><strong>Maximum CYP inhibition</strong> → inhibits <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> of other PI</li>\n<li>Low-dose <span class=\"customMeta\" data-dictid=\"dea585d18816927771975072308534\">ritonavir</span> boosts other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors (Lopinavir)</li>\n</ul>\n</li>\n<li>Amprenavir</li>\n<li>Fos-amprenavir</li>\n<li>Tipranavir</li>\n<li>Indinavir</li>\n<li>Saquinavir (least CYP inhibitor)</li>\n<li>Lopinavir</li>\n<li>Atazanavir (no dyslipidemia)</li>\n<li>Nelfinavir</li>\n<li>Darunavir (maximum bioavailability, taken with food)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Resistance</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>P-glycoprotein efflux transporter</li>\n<li>Cross-resistance with other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following integrase inhibitors with their unique characteristics: 1. Cabotegravir a. Associated with rhabdomyolysis 2. Dolutegravir b. Intramuscular administered every 3 months 3. Raltegravir c. Safe in pregnancy and widely used in India 4. Elvitegravir d. Used in combination with Cobicistat", "options": [{"label": "A", "text": "1:b, 2:c, 3:a, 4:d", "correct": true}, {"label": "B", "text": "1:c, 2:b, 3:a, 4:d", "correct": false}, {"label": "C", "text": "1:c, 2:b, 3:d, 4:a", "correct": false}, {"label": "D", "text": "1:b, 2:c, 3:d, 4:a", "correct": false}], "correct_answer": "A. 1:b, 2:c, 3:a, 4:d", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevent the formation of <span class=\"customMeta\" data-dictid=\"d7f598a3db1692777185bf93a6e6fa\">covalent</span> bonds between host and <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA.</li>\n<li>Inhibit DNA called<strong> <span class=\"customMeta\" data-dictid=\"cf25c7ba04169277719946f465928b\">strand</span> transfer.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>(ends with the word -gravir): <strong>BCDER</strong></p>\n<ul>\n<li>Bictegravir</li>\n<li>Cabotegravir</li>\n<li>Dolutegravir (most used in India and safe during pregnancy)</li>\n<li><strong>Elvitegravir</strong> (used in combination with cobicistat)</li>\n<li>Raltegravir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Route</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>All oral drugs except <strong>Cabotegravir</strong> (IM, once every 3 months)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CYP3A4 substrates</li>\n<li>Rifampicin reduces the effect, hence increasing the dose of the integrase inhibitor</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treatment and post-exposure <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of HIV</li>\n<li>Dolutegravir and Lamivudine: First line in treatment-naive <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rashes</li>\n<li>Steven Johnson syndrome: <span class=\"customMeta\" data-dictid=\"e4c62a77731692777187b9c7ded25d\">Epidermis</span> of the skin is damaged</li>\n<li>Raltegravir: Rhabdomyolysis, DRESS</li>\n<li>Bictegravir: Increase metformin concentration, hepatoxicity</li>\n<li>Avoid administration with <span class=\"customMeta\" data-dictid=\"9c9c29820b169277718670a8b16a3b\">divalent</span> cations (magnesium- or aluminium-containing antacids, iron supplements)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old HIV-1 positive primigravida who has been adherent to her antiretroviral therapy with a consistently low viral load delivers a full-term baby boy. What is the most appropriate drug of choice to reduce the risk of HIV transmission in this neonate?", "options": [{"label": "A", "text": "Zidovudine", "correct": false}, {"label": "B", "text": "Efavirenz", "correct": false}, {"label": "C", "text": "Nevirapine", "correct": true}, {"label": "D", "text": "Nevirapine + Zidovudine", "correct": false}], "correct_answer": "C. Nevirapine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-color:#000000; border-style:solid\">\n<p style=\"text-align:center\"><strong>Non-nucleoside <span class=\"customMeta\" data-dictid=\"2c764fcf7316927771978d26033b04\">reverse transcriptase</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (NNRTI)- Safe in pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Drug</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Zidovudine</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Nevirapine (NVP)</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Efavirenz</strong> <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Metabolism</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>No CYP enzyme</p>\n<p>interaction</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>CYP3A4 inducer</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Mixed (inducer and inhibitor)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Use</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>1. Used for <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> in:</p>\n<ul>\n<li>Mother with <strong>HIV-2 </strong>or HIV-1+HIV-2 co-infection (viral load &lt;1000 copies/ml)</li>\n<li>Mother <strong>received NVP</strong> during past pregnancy</li>\n<li>Mother on<strong> PI-based ART</strong> regimen.</li>\n</ul>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>1. First line for HIV-1 <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> in low-risk infants (viral load <strong>&lt;1000 </strong>copies/ml)</p>\n\t\t\t \n\n\t\t\t<p>2. Treatment in adults and children</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Treatment of HIV-1 in adults &amp; children &gt; 3 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Side effects</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Erythrocytic macrocytosis</li>\n<li>Insomnia</li>\n<li>Nail hyperpigmentation</li>\n<li>Skeletal myopathy</li>\n<li>Hepatotoxicity</li>\n</ul>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Hepatotoxicity,</li>\n<li>Rash, pruritus</li>\n<li>Steven-Johnson syndrome</li>\n<li>Lower <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> levels of coadministered CYP3A4 substrates\n\t\t\t\t<ul>\n<li>Methadone withdrawal</li>\n<li>Contraceptive failure</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>CNS effects\n\t\t\t\t<ul>\n<li>Insomnia, Depression</li>\n<li>Psychosis, dysphoria</li>\n<li>Peripheral neuropathy</li>\n</ul>\n</li>\n<li>Increase cholesterol</li>\n<li>Lower levels of <span class=\"customMeta\" data-dictid=\"3314c4671d1692777186457b78ae76\">efavirenz</span> with phenobarbital, phenytoin, and carbamazepine.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are true about tenofovir except", "options": [{"label": "A", "text": "It is an NRTI (nucleotide reverse transcriptase inhibitor) that requires phosphorylation activation.", "correct": true}, {"label": "B", "text": "Tenofovir disoproxil is a shorter-acting salt with a high risk of acute renal failure.", "correct": false}, {"label": "C", "text": "It is used in the treatment of both HIV and Hepatitis B.", "correct": false}, {"label": "D", "text": "It is not recommended for children under 10 years or those with pre-existing renal disease.", "correct": false}], "correct_answer": "A. It is an NRTI (nucleotide reverse transcriptase inhibitor) that requires phosphorylation activation.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid\">\n<p style=\"text-align:center\"><strong>Tenofovir (Nucleotide <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> RTI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>MOA</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li><strong>No <span class=\"customMeta\" data-dictid=\"619ba5e99c16927771958308fb8687\">phosphorylation</span> required (Option A)</strong></li>\n<li>Competitively inhibits <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> reverse transcriptase</li>\n<li>Incorporates into <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> DNA, causing chain <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">termination</span> (due to incomplete <span class=\"customMeta\" data-dictid=\"387285772b16927771979217d6cd30\">ribose</span> ring)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Types</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Tenofovir disoproxil: short-acting, more side effects <strong>(Option B)</strong></li>\n<li>Tenofovir alafenamide: long-acting</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Uses</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>DOC for HIV</li>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">Hepatitis</span> B virus + <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> <strong>(Option C)</strong></li>\n<li>HIV preexposure <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> (in combination with emtricitabine)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Side effect</p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Nephrotoxic (Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure)\n\t\t\t\t<ul>\n<li>Regular <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> and <span class=\"customMeta\" data-dictid=\"bfea0730ac16927771959eb551740f\">phosphorus</span> monitoring.</li>\n<li>Avoid with NSAIDs</li>\n</ul>\n</li>\n<li>Fanconi syndrome (causes damage to <span class=\"customMeta\" data-dictid=\"406aede9e21692777194b4cefe9958\">PCT</span> of nephron)\n\t\t\t\t<ul>\n<li>Leads to <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> loss</li>\n<li>Hypophosphatemic rickets, osteoporosis</li>\n</ul>\n</li>\n<li>Hepatitis B <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> with abrupt discontinuation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p>Contraindication<strong>(Option D)</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Renal disease (High creatinine)\n\t\t\t\t<ul>\n<li>Replace <span class=\"customMeta\" data-dictid=\"8ed4f962f416927772008ece0f551e\">tenofovir</span> with <span class=\"customMeta\" data-dictid=\"929423b7711692777202c3adc5f32c\">Zidovudine</span> or Abacavir</li>\n</ul>\n</li>\n<li>Child &lt; 10 years</li>\n<li>Weight &lt; 30 kg</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-year-old child diagnosed with HIV is scheduled to begin therapy with nucleoside reverse transcriptase inhibitors (NRTIs). His baseline laboratory tests reveal a haemoglobin level of 8.8 g/dL. Which of the following drugs should be avoided in this patient?", "options": [{"label": "A", "text": "Abacavir", "correct": false}, {"label": "B", "text": "Lamivudine", "correct": false}, {"label": "C", "text": "Zidovudine", "correct": true}, {"label": "D", "text": "Emtricitabine", "correct": false}], "correct_answer": "C. Zidovudine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side Effects of NRTIs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common side effect</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</li>\n<li>Alopecia</li>\n<li>Myopathy</li>\n<li>Pancreatitis</li>\n<li>Peripheral neuropathy</li>\n<li>Hepatic steatosis</li>\n<li>Lipodystrophy: Obese, <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> DM</li>\n<li>Lactic acidosis: <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of human mitochondrial respiration</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zidovudine</strong><br/>\n<strong>(Option C)</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</strong> (maximum risk): anaemia, leukopenia\n\t\t\t\t<ul>\n<li><strong>Contraindicated: Severe anaemia if Hb &lt;9 gm/dl</strong></li>\n<li>Treatment: <span class=\"customMeta\" data-dictid=\"ec50ec51401692777187009530441d\">Erythropoietin</span> injections</li>\n</ul>\n</li>\n<li>Erythrocytic macrocytosis</li>\n<li>Nail hyperpigmentation</li>\n<li>Alopecia, <span class=\"customMeta\" data-dictid=\"2bed7a5c011692777193cf17eb29b3\">myopathy</span> (due to <span class=\"customMeta\" data-dictid=\"7061e0e0051692777186ba9c5f27df\">depletion</span> of mitochondrial DNA)</li>\n<li>Hepatotoxicity and steatosis</li>\n<li>Insomnia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Didanosine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Pancreatitis</strong> (maximum risk)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stavudine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Maximum risk for:</p>\n<ul>\n<li><strong>Peripheral neuropathy</strong></li>\n<li>Hepatic steatosis</li>\n<li><strong>Lipodystrophy</strong></li>\n<li>Lactic acidosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abacavir</strong><br/>\n<strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Steven-Johnson syndrome</strong> (fatal hypersensitivity) with HLAB 5701 (Contraindicated if tested positive)\n\t\t\t\t<ul>\n<li>Fever, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, and <span class=\"customMeta\" data-dictid=\"dc75edd604169277719735ac5b4d5b\">rash</span> within 6 weeks of starting abacavir necessitates immediate discontinuation</li>\n</ul>\n</li>\n<li>Myocardial infarction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Emtricitabine</strong><br/>\n<strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Skin <span class=\"customMeta\" data-dictid=\"30261213bf16927771898b5d2f245d\">hyperpigmentation</span> in sun-exposed areas</li>\n<li>Exacerbation of <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> B with abrupt discontinuation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lamivudine</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Exacerbation of <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> B with abrupt discontinuation (Safest NRTI)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Never combined NRTIs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased toxicity: Stavudine, <span class=\"customMeta\" data-dictid=\"d31039ed501692777186b2bbdfdec8\">Didanosine</span> and Zalcitabine</li>\n<li>Cross-resistance:\n\t\t\t\t<ul>\n<li>Lamivudine and Emtricitabine</li>\n<li>Zidovudine and Stavudine</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 34 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient is diagnosed with bilateral pneumonia that is caused by an extended-spectrum beta-lactamase-producing Klebsiella. Which of the following is the drug of choice in this patient?", "options": [{"label": "A", "text": "Amoxicillin-clavulanic acid", "correct": true}, {"label": "B", "text": "Ofloxacin-tinidazole", "correct": false}, {"label": "C", "text": "Ceftriaxone-doxycycline", "correct": false}, {"label": "D", "text": "Benzylpenicillin-sulbactam", "correct": false}], "correct_answer": "A. Amoxicillin-clavulanic acid", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amoxicillin, ticarcillin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clavulanic acid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ampicillin, cefoperazone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sulbactam</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Piperacillin, ceftolozane</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tazobactam</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Meropenem</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vaborbactam</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Imipenem</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Relebactam</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ceftazidime</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Avibactam</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All are true about colistin except?", "options": [{"label": "A", "text": "It is primarily used as a last-resort treatment for multidrug-resistant bacterial infections.", "correct": false}, {"label": "B", "text": "It is associated with potential nephrotoxic and neurotoxic side effects.", "correct": false}, {"label": "C", "text": "It is known for its efficacy against gram-negative bacteria.", "correct": false}, {"label": "D", "text": "It is primarily administered via oral route.", "correct": true}], "correct_answer": "D. It is primarily administered via oral route.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:683px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Colistin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Polypeptide antibiotic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Administration: IV or via inhalation </strong></li>\n<li>Distribution: Poor <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> into tissues, primarily stays in the blood</li>\n<li>Metabolism: Minimal metabolism</li>\n<li>Excretion: Primarily excreted unchanged in urine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Colistin ⟶ Binds to Lipopolysaccharides (LPS) in <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> Bacterial Cell Walls ⟶ Disrupts <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> Integrity ⟶ Increases <span class=\"customMeta\" data-dictid=\"1c7103a9b516927771955682b6aaa4\">Permeability</span> of Cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> ⟶ Leakage of <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">Intracellular</span> Contents ⟶ Bacterial Cell Death</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Multidrug-resistant <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> bacterial infections (Option C)</strong>\n<ul>\n<li>Pseudomonas</li>\n<li>Acinetobacter</li>\n<li>Klebsiella pneumoniae</li>\n<li>Escherichia coli</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Ventilator-associated <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (VAP)</li>\n<li>Catheter-associated UTI</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Nephrotoxicity (Option B)</strong></li>\n<li><strong>Neurotoxicity (paresthesias, dizziness, confusion) (Option B)</strong></li>\n<li>Respiratory depression (with <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> use)</li>\n<li>Hypersensitivity reactions (rare)</li>\n<li>Neuromuscular <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> (rare)</li>\n<li>Superinfection (especially with prolonged use) (rare)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Due to its <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> profile and risk of resistance development, it is considered a <strong>last-line option for treating multidrug-resistant <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> infections (Option A).</strong></li>\n<li>Inhalation treats <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> infections, particularly in <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> patients with <span class=\"customMeta\" data-dictid=\"dea08f9dd81692777196a5f62e6862\">Pseudomonas</span> aeruginosa colonisation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male patient is admitted to the ICU for ventilator-associated pneumonia. He has been on mechanical ventilation for the past 48 hours due to respiratory failure secondary to severe sepsis. Cultures from his sputum reveal vancomycin-resistant organisms. What would be the preferred drug for this condition?", "options": [{"label": "A", "text": "Cefepime", "correct": false}, {"label": "B", "text": "Meropenem", "correct": false}, {"label": "C", "text": "Linezolid", "correct": true}, {"label": "D", "text": "Daptomycin", "correct": false}], "correct_answer": "C. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Linezolid</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type/Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxazolidinone antibiotic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Administration</strong>: Oral or IV</li>\n<li><strong>Absorption</strong>: Well-absorbed orally, with <span class=\"customMeta\" data-dictid=\"cf91922bb816927771839a51f2d1e6\">bioavailability</span> of approximately 100%</li>\n<li><strong>Distribution</strong>: Widely distributed in body tissues, including the lungs, skin, and bone</li>\n<li><strong>Metabolism</strong>: Minimal metabolism</li>\n<li><strong>Excretion</strong>: Excreted unchanged in urine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Linezolid ⟶ Binds to the 50S Ribosomal Subunit ⟶ Inhibits <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">Initiation</span> of Protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ Blocks <span class=\"customMeta\" data-dictid=\"3e53f6980f1692777187044dd3f9e7\">Elongation</span> of <span class=\"customMeta\" data-dictid=\"53172b32401692777195efbbb6b2e8\">Peptide</span> Chains ⟶ Inhibits Bacterial Protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ <span class=\"customMeta\" data-dictid=\"1019212c0716927771822d4942335e\">Bacteriostatic</span> or <span class=\"customMeta\" data-dictid=\"501eeb4a9716927771827a72cc5476\">Bactericidal</span> Activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Methicillin-resistant <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">Staphylococcus</span> aureus (MRSA)</li>\n<li>Vancomycin-resistant <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">Staphylococcus</span> aureus (VRSA)</li>\n<li>Vancomycin-resistant <span class=\"customMeta\" data-dictid=\"0d41f61a301692777187afebabcf09\">Enterococcus</span> (VRE)</li>\n<li>Streptococcus pneumoniae</li>\n<li>Complicated skin and skin structure infections</li>\n<li>Nosocomial <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (including those caused by MRSA)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and vomiting</li>\n<li>Diarrhea</li>\n<li>Rash</li>\n<li><strong>Thrombocytopenia</strong></li>\n<li><strong>Peripheral <span class=\"customMeta\" data-dictid=\"2d9476094c16927771933bcb162f19\">neuropathy</span> (with prolonged use)</strong></li>\n<li><strong>Serotonin syndrome</strong></li>\n<li>Lactic <span class=\"customMeta\" data-dictid=\"6caf3a39f416927771807e122b9032\">acidosis</span> (rare)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old female patient presents to the emergency department with severe abdominal pain, watery diarrhoea, and fever. She has a history of recent antibiotic use for a respiratory infection. Physical examination reveals abdominal tenderness and distension. A colonoscopy showed the presence of pseudomembranes. Based on these findings, what is the best treatment choice for this patient?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Metronidazole", "correct": false}, {"label": "C", "text": "Vancomycin", "correct": true}, {"label": "D", "text": "Azithromycin", "correct": false}], "correct_answer": "C. Vancomycin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male patient with a history of Staphylococcus aureus infection is being treated with antibiotics. During his treatment, he develops a sudden onset of flushing, redness of the upper body, and pruritus (itching). Which drugs are most likely responsible for the patient's condition?", "options": [{"label": "A", "text": "Vancomycin", "correct": true}, {"label": "B", "text": "Aztreonam", "correct": false}, {"label": "C", "text": "Ciprofloxacin", "correct": false}, {"label": "D", "text": "Ceftriaxone", "correct": false}], "correct_answer": "A. Vancomycin", "question_images": ["https://image.prepladder.com/content/wQDjjMs9EBLkMoq21jcM1724221718.png"], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\">\n<tbody>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p style=\"text-align:center\"><strong>Common</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<p style=\"text-align:center\"><strong>Rare</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Nephrotoxicity (especially with prolonged use or high doses).</li>\n<li>Ototoxicity (especially with rapid <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> or high doses).</li>\n<li>Thrombophlebitis at IV site.</li>\n</ul>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Neutropenia.</li>\n<li>Anaphylaxis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/klyU9xR5ISBPVIi4pPyp1746258025.mp3", "video": ""}, {"text": "All are true regarding aztreonam except?", "options": [{"label": "A", "text": "Used primarily to treat Gram-negative bacterial infections.", "correct": false}, {"label": "B", "text": "It can be administered both orally and intravenously.", "correct": true}, {"label": "C", "text": "It has a low cross-reactivity with penicillins, making it suitable for patients with penicillin allergies.", "correct": false}, {"label": "D", "text": "Primarily undergoes renal excretion and requires dose adjustment in patients with renal impairment.", "correct": false}], "correct_answer": "B. It can be administered both orally and intravenously.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:640px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aztreonam</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monobactam Antibiotic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Absorption:<strong> Administered IV or IM </strong></li>\n<li>Distribution: Widely distributed in the body, including CSF</li>\n<li>Metabolism: Minimal metabolism</li>\n<li>Excretion: <strong>Primarily excreted unchanged in urine, requires <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> dose adjustment in patients with <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment. (Option D) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aztreonam ⟶ Binds to Penicillin-Binding Proteins (PBPs) ⟶ Inhibits <span class=\"customMeta\" data-dictid=\"8d8d5e23f3169277719592e0c8d2b4\">Peptidoglycan</span> <span class=\"customMeta\" data-dictid=\"2cf4952c63169277718543a0883583\">Cross-linking</span> ⟶ <span class=\"customMeta\" data-dictid=\"5744dac7511692777186db6f8e0c28\">Disruption</span> of Bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">Cell Wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">Synthesis</span> ⟶ Cell <span class=\"customMeta\" data-dictid=\"803b5ed1c8169277719190b446ac83\">Lysis</span> ⟶ Bacterial Death</p>\n\t\t\t \n\n\t\t\t<p>Resistant to beta-lactamases, but <span class=\"customMeta\" data-dictid=\"55691242bb1692777199360f64cb67\">susceptible</span> to metallo-beta-lactamases and extended-spectrum beta-lactamases (ESBLs).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment of<strong> <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> </strong>bacterial infections<strong> (e.g. <span class=\"customMeta\" data-dictid=\"361c327ab81692777198a1cd507e57\">Salmonella</span> typhi, Pseudomonas), not effective against <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">Gram-positive</span> bacteria or Anaerobes. (Option A) </strong></p>\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (UTIs)</li>\n<li>Lower <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Septicemia</li>\n<li>Skin and skin structure infections</li>\n<li>Intra-abdominal infections</li>\n<li>Gynecological infections</li>\n</ul>\n<p>It is particularly useful for patients allergic to penicillins or cephalosporins.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common:</p>\n<ul>\n<li>Rash</li>\n<li>Nausea and Vomiting</li>\n<li>Diarrhea</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Serious:</p>\n<ul>\n<li>Hypersensitivity reactions (anaphylaxis)</li>\n<li>Clostridium difficile-associated diarrhoea</li>\n<li>Hepatotoxicity</li>\n<li>Neutropenia and thrombocytopenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It can be used in patients wit<strong>h <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> due to low cross-reactivity, except for Ceftazidime. (Option C) </strong></li>\n<li>Often combined with beta-lactamase inhibitors (Avibactam) to expand the spectrum.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male patient residing in Delhi presents to the emergency department with fever, chills, hypotension, and altered mental status. Blood cultures are positive for a gram-negative bacillus. The patient is diagnosed with sepsis, and subsequent laboratory testing reveals that the causative organism produces New Delhi metallo-beta-lactamase (NDM-1). Given this information, which of the following is the best treatment choice?", "options": [{"label": "A", "text": "Meropenem", "correct": false}, {"label": "B", "text": "Piperacillin-tazobactam", "correct": false}, {"label": "C", "text": "Ceftazidime-avibactam", "correct": true}, {"label": "D", "text": "Amoxicillin-clavulanate", "correct": false}], "correct_answer": "C. Ceftazidime-avibactam", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient initially admitted to the intensive care unit with respiratory failure was escalated to invasive ventilation. Few days later, he developed a fever along with basal crackles and patchy consolidation can be seen in chest X-ray. Which of the following is the drug of choice for this patient?", "options": [{"label": "A", "text": "Cefoperazone-sulbactam", "correct": false}, {"label": "B", "text": "Imipenem-cilastatin", "correct": true}, {"label": "C", "text": "Piperacillin-tazobactam", "correct": false}, {"label": "D", "text": "Amoxicillin-clavulanate", "correct": false}], "correct_answer": "B. Imipenem-cilastatin", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who initially presented with symptoms of staphylococcal scalded skin syndrome is found to be methicillin-resistant. The report also said vancomycin would also be ineffective in this organism. Which of the following cephalosporins can most likely be used effectively in this patient?", "options": [{"label": "A", "text": "Cefetamet pivoxil", "correct": false}, {"label": "B", "text": "Cefuroxime axetil", "correct": false}, {"label": "C", "text": "Cefpodoxime proxetil", "correct": false}, {"label": "D", "text": "Ceftaroline fosamil", "correct": true}], "correct_answer": "D. Ceftaroline fosamil", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>ENT, upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> &amp; <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> infections</li>\n<li><strong>Cephazolin is the DOC for <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> site infection prophylaxis </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mixed aerobic-anaerobic infections<strong> (Only <span class=\"customMeta\" data-dictid=\"626f0bd24b1692777184b5820daf5c\">cephalosporin</span> class effective against anaerobes)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Third generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ceftriaxone/Cefotaxime</strong>: <span class=\"customMeta\" data-dictid=\"95c41bced21692777187fa909c1937\">empirical</span> therapy for meningitis</li>\n<li><strong>Ceftazidime</strong>: <span class=\"customMeta\" data-dictid=\"dea08f9dd81692777196a5f62e6862\">Pseudomonas</span> meningitis</li>\n<li>STI : Gonorrhea, chancroid, syphilis</li>\n<li>Enteric fever</li>\n<li>Patients with <strong>neutropenia</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fourth generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nosocomial infections (<strong>intensive care borne</strong>)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Fifth generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Penicillin resistant</strong> community <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> and hospital <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> by S.pneumoniae</li>\n<li><strong>Penicillinase producing</strong> S.aureus infections</li>\n<li><strong>MRSA</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a 4th generation cephalosporin?", "options": [{"label": "A", "text": "Ceftaroline", "correct": false}, {"label": "B", "text": "Cefnidir", "correct": false}, {"label": "C", "text": "Cefpirome", "correct": true}, {"label": "D", "text": "Ceftament", "correct": false}], "correct_answer": "C. Cefpirome", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:620px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1st gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2nd gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3rd gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4th gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5th gen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cephazolin <strong>(Option B ruled out)</strong></p>\n<p>Cephalexin</p>\n<p>Cefadroxil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cefuroxime</p>\n<p>Cefoxitin</p>\n<p>Cefaclor</p>\n<p>Cefprozil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cefixime <strong>(Option A ruled out)</strong></p>\n<p>Cefotaxime</p>\n<p>Ceftizoxime</p>\n<p>Ceftriaxone</p>\n<p>Ceftazidime</p>\n<p>Cefpodoxime proxetil</p>\n<p>Cefdinir <strong>(Option D ruled out)</strong></p>\n<p>Ceftibuten</p>\n<p>Ceftamet pivoxil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cefepime</p>\n<p><strong>Cefpirome (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ceftaroline</p>\n<p>Ceftobiprole</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following drugs correctly match their mechanism of action. 1. Cycloserine a. Inhibits enzyme bactoprenol dephosphorylase 2. Fosfomycin b. Inhibits enzyme transpeptidase 3. Monobactam c. Inhibits enzyme enol pyruvate transferase 4. Bacitracin d. Inhibits enzyme alanine racemase and ligase", "options": [{"label": "A", "text": "1:d , 2:c , 3:b , 4:a", "correct": true}, {"label": "B", "text": "1:b , 2:c , 3:d , 4:a", "correct": false}, {"label": "C", "text": "1:d , 2:a , 3:b , 4:c", "correct": false}, {"label": "D", "text": "1:d , 2:b , 3:a , 4:c", "correct": false}], "correct_answer": "A. 1:d , 2:c , 3:b , 4:a", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2BRv5wkIlFLldq3sofGS1724221568.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:755px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Cell wall <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits transpeptidase (penicillin-binding protein) and prevents cross-linking</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Beta-lactam drugs</p>\n<p>1. Penicillin</p>\n<p>2. Cephalosporin</p>\n<p>3. Carbapenems</p>\n<p>4. <strong>Monobactam</strong> (Aztreonam)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MSSA infections</li>\n<li>Perioperative prophylaxis</li>\n<li>Syphilis</li>\n<li>Meningitis</li>\n<li>Community-acquired pneumonia</li>\n<li>GI and GU infection</li>\n<li>Aztreonam in <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> allergy.</li>\n<li>Ertapenam in ESBL, P. aeruginosa, and Acinetobacter</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Hypersensitivity</p>\n<p>2. Cross <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> (except monobactams)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"57a27d06931692777187a88d754b8f\">enol</span> <span class=\"customMeta\" data-dictid=\"f9129e152d16927771960c4ccc40bc\">pyruvate</span> <span class=\"customMeta\" data-dictid=\"2288cbf3741692777200318d2f5b39\">transferase</span> and block GAG synthesis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fosfomycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enterococcal UTI (Foley's catheter)</li>\n<li>Transurethral procedures</li>\n<li>Safe in pregnancy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Hematuria</p>\n<p>2. Urinary discomfort</p>\n<p>3. Neuropsychiatric: Psychosis, seizures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D-alanine <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> inhibits <span class=\"customMeta\" data-dictid=\"7f4e6edbc91692777181c6fa295ae7\">alanine</span> <span class=\"customMeta\" data-dictid=\"8208c3e86b1692777197c49134ede1\">racemase</span> and ligase</p>\n<p>(<strong>Bacteriostatic</strong>)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cycloserine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Multidrug resistant TB</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Neurotoxicity</p>\n<p>2. Psychosis</p>\n<p>3. Depression (Suicide risk)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits bactoprenol dephosphorylase enzyme</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacitracin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topical cream in <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> <span class=\"customMeta\" data-dictid=\"57640139fe169277718418f95ae49f\">cocci</span> (Staphylococcus and Streptococcus) skin infection</li>\n<li>Oral: Enterococcal infection</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Nephrotoxic (IV)</p>\n<p>2. Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of transglucosidase enzyme</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vancomycin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pseudomembranous colitis(oral)</li>\n<li>MRSA</li>\n<li>E. faecalis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Nephrotoxicity</p>\n<p>2. Ototoxicity</p>\n<p>3. Red man syndrome</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xeQ8wWHapapN3j85OSAk1747763212.mp3", "video": ""}, {"text": "A patient who was admitted with suspected osteomyelitis is found to be caused by Staphylococcus aureus that shows resistance to methicillin. Which of the following is least likely to be the drug of choice for this patient?", "options": [{"label": "A", "text": "Teicoplanin", "correct": false}, {"label": "B", "text": "Chloramphenicol", "correct": true}, {"label": "C", "text": "Linezolid", "correct": false}, {"label": "D", "text": "Vancomycin", "correct": false}], "correct_answer": "B. Chloramphenicol", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are true regarding penicillinase-resistant penicillins except?", "options": [{"label": "A", "text": "Dicloxacillin falls in this group of drugs.", "correct": false}, {"label": "B", "text": "Methicillin is preferred in patients with renal disease.", "correct": true}, {"label": "C", "text": "Not resistant to penicillinase of gram-negative bacteria.", "correct": false}, {"label": "D", "text": "Concomitant use of contraceptive pills is contraindicated with nafcillin.", "correct": false}], "correct_answer": "B. Methicillin is preferred in patients with renal disease.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:504px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Penicillinase-resistant penicillins</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cloxacillin (oral)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coagulation defect/bleeding</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxacillin (oral)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nafcillin (IV)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neutropenia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dicloxacillin (oral) <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following statements are incorrect about extended spectrum penicillins except?", "options": [{"label": "A", "text": "Ampicillin is one of the preferred drugs of choice in typhoid fever.", "correct": false}, {"label": "B", "text": "The biliary concentration of ampicillin is low and hence not used in cholecystitis.", "correct": false}, {"label": "C", "text": "Piperacillin is more potent than carbenicillin in pseudomonas infections.", "correct": true}, {"label": "D", "text": "Carbenicillin is the preferred drug in this group in heart failure patients.", "correct": false}], "correct_answer": "C. Piperacillin is more potent than carbenicillin in pseudomonas infections.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old male recently began treatment for painless lesions in his palms and soles and presented to the emergency department with fever, chills, and myalgias. These symptoms developed a few hours after receiving his first dose of benzathine penicillin G. On examination, he appears flushed (image) with tachycardia and hypotension. Based on the findings, match the most likely diagnosis and management of this condition. 1. Anaphylactic reaction A. Continue medication and start antipyretics 2. Serum Sickness B. Administer epinephrine 3. Jarisch-Herxheimer reaction C. Discontinue and switch to alternate medication 4. Steven-Johnson syndrome D. Discontinue medication and admit to ICU", "options": [{"label": "A", "text": "3 and B", "correct": false}, {"label": "B", "text": "2 and C", "correct": false}, {"label": "C", "text": "3 and A", "correct": true}, {"label": "D", "text": "4 and D", "correct": false}], "correct_answer": "C. 3 and A", "question_images": ["https://image.prepladder.com/content/YKlGkHS0E96XRs47XHQ51724221643.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old male presents to the hospital with headaches, difficulty coordinating his movements, and memory loss over the past six months. On physical examination, his pupils are irregular and do not constrict to light but constrict during accommodation. He had a history of painless genital ulcer, which was resolved on its own a few years ago. What is the drug of choice used for this condition in this patient?", "options": [{"label": "A", "text": "A single dose of 2.4 million IU penicillin G", "correct": false}, {"label": "B", "text": "Once weekly dose of 2.4 million IU penicillin G", "correct": false}, {"label": "C", "text": "Once weekly dose of 24 million IU penicillin G", "correct": false}, {"label": "D", "text": "Continues dose of 24 million IU penicillin G", "correct": true}], "correct_answer": "D. Continues dose of 24 million IU penicillin G", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Stages of Syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Primary syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chancre (painless <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> ulcer)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single IM <span class=\"customMeta\" data-dictid=\"b81b3b03a21692777182c4a1cd4bbe\">Benzathine penicillin</span> 2.4 million IU <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Secondary syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spread in blood: Rash involving palms and soles, uveitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single IM <span class=\"customMeta\" data-dictid=\"b81b3b03a21692777182c4a1cd4bbe\">Benzathine penicillin</span> 2.4 million IU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Early <span class=\"customMeta\" data-dictid=\"cec2565ecd1692777191eed58869b2\">latent</span> syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dormant for &lt; 1 year</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single IM <span class=\"customMeta\" data-dictid=\"b81b3b03a21692777182c4a1cd4bbe\">Benzathine penicillin</span> 2.4 million IU</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Late <span class=\"customMeta\" data-dictid=\"cec2565ecd1692777191eed58869b2\">latent</span> syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dormant for &gt; 1 year</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Weekly IM <span class=\"customMeta\" data-dictid=\"b81b3b03a21692777182c4a1cd4bbe\">Benzathine penicillin</span> 2.4 million IU for three weeks <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tertiary syphilis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activation after one year and damages the organs (gummas)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Weekly IM <span class=\"customMeta\" data-dictid=\"b81b3b03a21692777182c4a1cd4bbe\">Benzathine penicillin</span> 2.4 million IU for three weeks <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Damage to heart: Cardiovascular <span class=\"customMeta\" data-dictid=\"23f8d40f6a1692777199029dbec026\">syphilis</span> (aortic aneurysm, arteritis)</p>\n<p>Damage to the brain: <span class=\"customMeta\" data-dictid=\"c53294ec0b1692777193ea053eeb6b\">Neurosyphilis</span> (tabes dorsalis, ataxia, dementia, Argyl Robertson pupils)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Continues IV Aqueous <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">Penicillin</span> G 18-24 IU for 10-14 days. <strong>(Option</strong><strong> D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding penicillins is true? Acid-stable penicillins are destroyed by gastric acid and must be administered parenterally. Penicillin G is an acid-stable penicillin that should be given in high doses if administered orally. Acid-stable penicillins are avoided with food and antacids. Acid labile penicillins include amoxicillin, ampicillin and oxacillin.", "options": [{"label": "A", "text": "1, 3 and 4", "correct": false}, {"label": "B", "text": "2 and 3", "correct": false}, {"label": "C", "text": "3 and 4", "correct": false}, {"label": "D", "text": "3 only", "correct": true}], "correct_answer": "D. 3 only", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Acid Labile Penicillin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Acid Stable Penicillin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Penicillin G</strong> is <strong>degraded</strong> in the stomach by HCl <strong>(Statement 2)</strong></li>\n<li>Route:\n\t\t\t\t<ul>\n<li><strong>Parenteral</strong></li>\n<li>If oral necessary: given in <strong>high doses</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Resistant to <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> HCl <strong>(Statement 1)</strong></li>\n<li>Route: <strong>Oral</strong></li>\n<li>Drugs: <strong>Mnemonic: VODCAA</strong>\n<ul>\n<li><strong>Penicillin V</strong> (No effect on meningococcus)</li>\n<li>Oxacillin</li>\n<li>Dicloxacillin, Flucloxacillin</li>\n<li>Cloxacillin</li>\n<li><strong>Ampicillin</strong></li>\n<li><strong>Amoxicillin (Statement 4)</strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Avoid food and antacids</strong> except for amoxicillin <strong>(Statement 3)</strong></li>\n<li>Given 30 mins before food or &gt;2 <span class=\"customMeta\" data-dictid=\"136c4bdd441692777189c5b2e976a0\">hrs</span> after food</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old female presents to the clinic with a sore throat and fever for three days. Previous medical history includes breathing issues and rashes caused by an unknown medicine used to treat syphilis one year ago. A throat swab confirms the streptococcal infection. What is the best treatment option for this patient?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Ceftriaxone", "correct": false}, {"label": "C", "text": "Erythromycin", "correct": true}, {"label": "D", "text": "Penicillin V", "correct": false}], "correct_answer": "C. Erythromycin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 19-year-old college student arrives at the emergency room complaining of photophobia, high fever and severe headache. A physical examination reveals pain when extending the legs and stiffness on neck flexion. Following a lumbar puncture, the cerebrospinal fluid was cloudy, with high protein, low glucose and raised white blood cell count. What is the most appropriate treatment of choice for this patient?", "options": [{"label": "A", "text": "Intravenous Acyclovir", "correct": false}, {"label": "B", "text": "Intravenous Vancomycin", "correct": false}, {"label": "C", "text": "Intravenous Ceftriaxone", "correct": true}, {"label": "D", "text": "Intravenous Amphotericin", "correct": false}], "correct_answer": "C. Intravenous Ceftriaxone", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Meningococcal Meningitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causative organism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Neisseria meningitidis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC: IV Ceftriaxone (Third generation cephalosporin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prophylaxis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Adult: <span class=\"customMeta\" data-dictid=\"1f83ae1e461692777184d9acc4db71\">Ciprofloxacin</span> (earlier Rifampicin)\n\t\t\t\t<ul>\n<li>Prevents <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> colonisation</li>\n</ul>\n</li>\n<li>Children and Pregnant women:\n\t\t\t\t<ul>\n<li>Ceftriaxone <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> (as <span class=\"customMeta\" data-dictid=\"1f83ae1e461692777184d9acc4db71\">Ciprofloxacin</span> ( FQ) causes <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage in children and fetus).</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Penicillin is helpful for the treatment of all of the following conditions except?", "options": [{"label": "A", "text": "Streptococcal pharyngitis", "correct": false}, {"label": "B", "text": "Neurosyphilis", "correct": false}, {"label": "C", "text": "MRSA pneumonia", "correct": true}, {"label": "D", "text": "Leptospirosis", "correct": false}], "correct_answer": "C. MRSA pneumonia", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:672px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Penicillins</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Classification</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Natural</strong> Penicillins\n\t\t\t\t<ul>\n<li>Penicillin G/Benzylpenicillin/Crystalline penicillin\n\t\t\t\t\t<ul>\n<li>First penicillin</li>\n<li>Parenteral route only</li>\n<li>Allergic potential</li>\n<li>Narrow spectrum</li>\n<li>Resistance exhibited by beta-lactamase enzyme-producing organisms</li>\n<li> </li>\n</ul>\n</li>\n<li>Penicillin V: <span class=\"customMeta\" data-dictid=\"b36da50c8d169277718782ffc6960b\">Enteral</span> route</li>\n</ul>\n</li>\n<li><strong>Penicillinase resistant </strong>penicillin\n\t\t\t\t<ul>\n<li>Methicillin, cloxacillin, nafcillin, oxacillin, and dicloxacillin</li>\n</ul>\n</li>\n<li><strong>Aminopenicillins</strong>: Ampicillin, amoxicillin.</li>\n<li><strong>Anti-pseudomonal penicillins</strong>: Piperacillin, ticarcillin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pharmacokinetics</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Poor <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> (except <strong>Penicillin G</strong> and <strong>nafcillin</strong>)</li>\n<li>Poor eye penetration</li>\n<li>Poor <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> penetration</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses <strong>(SMART Player GAYLE</strong>)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>S: Syphilis:<strong> <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for</strong> <strong>neurosyphilis (Option B ruled out)</strong></li>\n<li>M: Meningococcal meningitis</li>\n<li>A: Actinomycosis</li>\n<li>R: Rat bite fever: Streptobacillus, Spirillosis</li>\n<li>T: Tetanus</li>\n<li>Player: <span class=\"customMeta\" data-dictid=\"11c8d7671c1692777194c38332292e\">Pasteurella</span> multocida</li>\n<li>G: Gas <span class=\"customMeta\" data-dictid=\"741c89cb18169277718889cfaafa53\">gangrene</span> (Myonecrosis): <span class=\"customMeta\" data-dictid=\"27791cc8181692777184b363360a3c\">Clostridium</span> perfringens</li>\n<li>A: Anthrax</li>\n<li>Y: Yaws</li>\n<li>L: <span class=\"customMeta\" data-dictid=\"6095dde7d916927771912b05cd4a92\">Leptospirosis</span> <strong>(Option D ruled out)</strong></li>\n<li>E: Every species: Streptococcus, <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">Staphylococcus</span> if sensitive <strong>(Option A ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following anti-tubercular drugs is NOT bactericidal?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Rifapentin", "correct": false}, {"label": "C", "text": "Thioacetazone", "correct": true}, {"label": "D", "text": "Kanamycin", "correct": false}], "correct_answer": "C. Thioacetazone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Thioacetazone</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Name of drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Isoniazid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rifampin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pyrazinamide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ethambutol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Streptomycin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"89e2535e2416927771930505f8f408\">mycolic acids</span> (cell wall).</p>\n<p>It also inhibits <span class=\"customMeta\" data-dictid=\"e99dbef99f169277719344843cf75a\">mycobacterium</span> DHFR, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with <span class=\"customMeta\" data-dictid=\"6483f3ef3116927771935d328a8ab2\">nucleic acid</span> synthesis.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Interrupts <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to mycobacterial DNA-dependent <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by getting converted into pyrazinoic acid</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in mycolic acid <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">incorporation</span> in the cell wall</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits 30S ribosomal protein synthesis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intramuscular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cellularity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intracellular</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bacteriostatic</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bacteria inhibited</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of resistance by lactamases to Beta-lactam antibiotics?", "options": [{"label": "A", "text": "Alteration of penicillin-binding proteins proteins", "correct": false}, {"label": "B", "text": "Degradation of antibiotics", "correct": true}, {"label": "C", "text": "Drug efflux", "correct": false}, {"label": "D", "text": "Alteration in 50s ribosome structure", "correct": false}], "correct_answer": "B. Degradation of antibiotics", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>ß-lactam antibiotics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>ß-lactam antibiotics <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the last step in <span class=\"customMeta\" data-dictid=\"8d8d5e23f3169277719592e0c8d2b4\">peptidoglycan</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by acylating the transpeptidase via <span class=\"customMeta\" data-dictid=\"db5610b3121692777184e0965a9fa4\">cleavage</span> of the -CO-N-bond of the ß-lactam ring, thus inhibiting <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> synthesis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug groups </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. Penicillin</p>\n<p>2. Cephalosporin</p>\n<p>3. Carbapenems</p>\n<p>4. <span class=\"customMeta\" data-dictid=\"ada14a9fa616927771929ac9bafce2\">Monobactam</span> (Aztreonam)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Resistance </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It occurs through one of the four mechanisms:</p>\n<ol>\n<li><strong>Modification</strong> of target <strong>PBPs</strong> <strong>(Option A)</strong></li>\n<li><strong>Impaired</strong> <strong>penetration</strong> of drugs to target PBPs</li>\n<li>Antibiotic <strong>efflux</strong> <strong>(Option C)</strong></li>\n<li>Inactivation of <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">antibiotic</span> by <strong>lactamases</strong> <strong>(Option B)</strong></li>\n</ol>\n<p>ß-lactamases are enzymes produced by certain bacteria that <span class=\"customMeta\" data-dictid=\"8bc8a6d0441692777190e9bed75e91\">inactivate</span> ß-lactam antibiotics by <span class=\"customMeta\" data-dictid=\"41255286461692777189199a8b2dc7\">hydrolysis</span> of the ß-lactam ring in their structure.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Voriconazole is not effective against which of the following?", "options": [{"label": "A", "text": "Candida albicans", "correct": false}, {"label": "B", "text": "Mucormycosis", "correct": true}, {"label": "C", "text": "Candida tropicalis", "correct": false}, {"label": "D", "text": "Aspergillosis", "correct": false}], "correct_answer": "B. Mucormycosis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Voriconazole </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is a <span class=\"customMeta\" data-dictid=\"032853dede169277720093484e7e18\">triazole</span> <span class=\"customMeta\" data-dictid=\"c929a2b71516927771812a8b7b7ec3\">antifungal</span> known for its broad spectrum against <span class=\"customMeta\" data-dictid=\"3655d8847516927772026e1e299f2a\">yeast</span> and moulds.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits fungal <span class=\"customMeta\" data-dictid=\"08a8798eef1692777199f2a6ba28f4\">sterol</span> 14α-demethylase, disrupting <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in fungal cell membranes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spectrum </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Broad spectrum against various fungi</p>\n<ul>\n<li>Candida albicans<strong> (Option A) </strong></li>\n<li>Candida tropicalis <strong>(Option B)</strong></li>\n<li>Aspergillosis <strong>(Option D) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Common: Nausea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, diarrhoea, headache, dizziness.</p>\n<p>Rare: Anaemia, neutropenia, <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias, visual disturbances.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs gets deposited in the cornea?", "options": [{"label": "A", "text": "Leflunomide", "correct": false}, {"label": "B", "text": "Chloroquine", "correct": true}, {"label": "C", "text": "Methotrexate", "correct": false}, {"label": "D", "text": "Salfalazine", "correct": false}], "correct_answer": "B. Chloroquine", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/i550vWBEEtaR9aQbjigF1746435536.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:663px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Chloroquine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Chloroquine accumulates in <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> compartments of parasite-infected cells, disrupting <span class=\"customMeta\" data-dictid=\"d4fff554a316927771885dc8700abe\">heme</span> polymerisation and inhibiting <span class=\"customMeta\" data-dictid=\"a59b97ce831692777194f6c0160f15\">parasite</span> growth and replication.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Due to mutations in genes <span class=\"customMeta\" data-dictid=\"b989cb3b0d1692777187dd7965b4d3\">encoding</span> transporters involved in <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> and efflux, reducing <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> accumulation within parasites.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Malaria Treatment and Prophylaxis</li>\n<li>Amebiasis</li>\n<li>Leprae reaction</li>\n<li>Giardiasis</li>\n<li>Autoimmune Diseases (RA, SLE)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>S/E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ophthalmic: <strong>Bull's eye maculopathy,</strong> <strong>anterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract, <span class=\"customMeta\" data-dictid=\"301da8b9181692777202486306bbd2\">vortex</span> keratopathy, corneal deposits</strong></li>\n<li>Gastrointestinal: Nausea, vomiting, diarrhea</li>\n<li>Skin: Itching, rash, photosensitivity</li>\n<li>Neuropsychiatric: Agitation, confusion, hallucinations</li>\n<li>Cardiac: QT prolongation, <span class=\"customMeta\" data-dictid=\"6e6dd7aed216927771831ebdf9703c\">cardiomyopathy</span> (rare)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following bacteria with the drug of choice used for each: Bacteria Drug of Choice A. Bacteroides 1. Vancomycin B. MRSA 2. Metronidazole C. Hemophilus 3. Meropenem D. Klebsiella 4. Penicillin", "options": [{"label": "A", "text": "A-1, B-3, C-4, D-2", "correct": false}, {"label": "B", "text": "A-2, B-1, C-4, D-3", "correct": true}, {"label": "C", "text": "A-3, B-4, C-1, D-2", "correct": false}, {"label": "D", "text": "A-4, B-1, C-2, D-3", "correct": false}], "correct_answer": "B. A-2, B-1, C-4, D-3", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - A-2, B-1, C-4, D-3</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Bacteria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Drug of Choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Bacteroides</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Metronidazole</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>MRSA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Vancomycin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Hemophilus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Penicillin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Klebsiella</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Meropenem</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A known asthmatic patient with a fever and sore throat was prescribed an antibiotic. Two days later, he presented with a maculopapular rash. Which of the following drugs might have caused this?", "options": [{"label": "A", "text": "Prednisolone", "correct": false}, {"label": "B", "text": "Salbutamol", "correct": false}, {"label": "C", "text": "Fexofenadine", "correct": false}, {"label": "D", "text": "Amoxicillin", "correct": true}], "correct_answer": "D. Amoxicillin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient with severe COVID-19, which of the following options is unlikely to provide significant assistance?", "options": [{"label": "A", "text": "Low molecular weight heparin", "correct": false}, {"label": "B", "text": "Oxygen", "correct": false}, {"label": "C", "text": "Favipiravir", "correct": true}, {"label": "D", "text": "Steroids", "correct": false}], "correct_answer": "C. Favipiravir", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Favipirav\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is classified as a second-line medication for treating tuberculosis?", "options": [{"label": "A", "text": "Streptomycin", "correct": false}, {"label": "B", "text": "Ethionamide", "correct": true}, {"label": "C", "text": "Acyclovir", "correct": false}, {"label": "D", "text": "Vancomycin", "correct": false}], "correct_answer": "B. Ethionamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Ethionamide</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Second-line ATT drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Group A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Group B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Group C</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bedaquilin</li>\n<li>Levofloxacin or Moxifloxacin</li>\n<li>Linezolid</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cycloserine</li>\n<li>Clofazimine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Delamanid</li>\n<li>Amikacin</li>\n<li>Meropenem or Imipenem-cilastatin</li>\n<li>PAS</li>\n<li><strong>Ethionamide</strong></li>\n<li>Ethambutol</li>\n<li>Pyrazinamide</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which topical antifungal exhibits both anti-inflammatory properties and provides relief from itching?", "options": [{"label": "A", "text": "Ketoconazole", "correct": false}, {"label": "B", "text": "Sertaconazole", "correct": true}, {"label": "C", "text": "Luliconazole", "correct": false}, {"label": "D", "text": "Terbinafine", "correct": false}], "correct_answer": "B. Sertaconazole", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the drug that decreases mortality in patients with COVID-19 among the options provided? A. Dexamethasone B. Remdesivir C. Favipiravir", "options": [{"label": "A", "text": "B and C", "correct": false}, {"label": "B", "text": "A and B", "correct": false}, {"label": "C", "text": "Only A", "correct": true}, {"label": "D", "text": "A, B, C", "correct": false}], "correct_answer": "C. Only A", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is an inhibitor of RNA synthesis?", "options": [{"label": "A", "text": "5-Fluorouracil", "correct": false}, {"label": "B", "text": "Rifampicin", "correct": true}, {"label": "C", "text": "Nitrofurantoin", "correct": false}, {"label": "D", "text": "Novobiocin", "correct": false}], "correct_answer": "B. Rifampicin", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DDsE1VDgjVhuixn5Z4UA1746436006.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Name of drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Rifampin</strong><br/>\n\t\t\t </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\">Interrupts <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to mycobacterial DNA-dependent <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase.</p>\n<p style=\"text-align:center\"><img alt=\"PH164\" data-author=\"\" data-hash=\"11838\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/DDsE1VDgjVhuixn5Z4UA1746436006.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Route</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cellularity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>RNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitors </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Rifampicin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibition of bacterial <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Antibiotic against <span class=\"customMeta\" data-dictid=\"8d98ce2d3616927772013bfc3e0528\">Tuberculosis</span> and Leprosy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Actinomycin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibition of DNA and <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anticancer agent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha <span class=\"customMeta\" data-dictid=\"b1f2ca95881692777181bb7e22d9d9\">Amanitin</span> </strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p>Inhibition of eukaryotic <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"d419920a6616927771969805c3d65d\">polymerase</span> II</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Found in mushrooms, no <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> use</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Triptolide </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Traditional Chinese medicine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Amatoxin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Found in mushrooms, no <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> use</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs should not be consumed by a patient with bacterial vaginosis and trichomoniasis currently on metronidazole?", "options": [{"label": "A", "text": "Grapefruit juice", "correct": false}, {"label": "B", "text": "Alcohol", "correct": true}, {"label": "C", "text": "Benzodiazepine", "correct": false}, {"label": "D", "text": "MAOI / SSRI", "correct": false}], "correct_answer": "B. Alcohol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:742px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Metronidazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prodrug is converted to active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> through <span class=\"customMeta\" data-dictid=\"bb349efe571692777193cd0d07baeb\">nitro</span> group reduction inside the bacteria → formation of <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> free radicals → causes DNA damage → inhibits replication.</li>\n<li>Inhibits PFOR <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> (pyruvate <span class=\"customMeta\" data-dictid=\"91d0e4c6fa16927772025f96b44b27\">ferritin</span> oxido reductase) in <span class=\"customMeta\" data-dictid=\"b87627c189169277719689567ed39e\">protozoa</span> → DNA damage.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Giardiasis (in HIV-positive patients)</li>\n<li>Entamoeba histolytica → <span class=\"customMeta\" data-dictid=\"1b0f3628231692777181232735c06b\">Amebic dysentery</span> &amp; amebic liver abscess</li>\n<li>Trichomonas vaginalis</li>\n<li>Bacterial Vaginosis</li>\n<li>Dracunculus (guinea worm)</li>\n<li>Gardenella / bacterial vaginosis</li>\n<li>Empiric <span class=\"customMeta\" data-dictid=\"b02812a466169277719090c2d27868\">intra-abdominal</span> and soft tissue <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections</li>\n<li>H. pylori <span class=\"customMeta\" data-dictid=\"7861e10657169277718815c2f42a75\">gastritis</span> (combined with <span class=\"customMeta\" data-dictid=\"9c823198d61692777196bc71097d6d\">proton</span> pump inhibitor)</li>\n<li>Prophylaxis for <span class=\"customMeta\" data-dictid=\"f04bf2125316927771847bfe139191\">colorectal</span> surgery</li>\n<li>Fulminant C.difficile infection (IV <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">metronidazole</span> + oral vancomycin)</li>\n<li>Mild to moderate Crohn's disease</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metallic taste, intensely bitter</li>\n<li>Headache, nausea, <span class=\"customMeta\" data-dictid=\"e3afd7f63b1692777186b9a6e7824d\">dry mouth</span> (most common)</li>\n<li>Vomiting, diarrhoea, and <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> distress</li>\n<li>Dysuria, cystitis, and a sense of <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> pressure</li>\n<li>Dizziness, vertigo,</li>\n<li>Neurotoxicity: <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> neuropathy, numbness, paresthesias, ataxia</li>\n<li>Brown color urine</li>\n<li>Urticaria, flushing, and <span class=\"customMeta\" data-dictid=\"c238cff71916927771965fb88e6cc4\">pruritus</span> ( rare cause of Stevens-Johnson syndrome)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug Interaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Inhibitor of CYP enzymes</li>\n<li>Disulfiram-like effect: <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> distress, vomiting, flushing, headache or <span class=\"customMeta\" data-dictid=\"1cb2d1482916927771964c2890313e\">psychosis</span> with <span class=\"customMeta\" data-dictid=\"0751b802aa169277718100e38a1276\">alcoholic</span> beverages during or within 3 days of therapy.</li>\n<li>Precipitate <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> toxicity</li>\n<li>Prothrombin time prolongation with <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> (anticoagulant).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>CNS diseases</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> disease</li>\n<li>First <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is Remdesivir's mechanism of action?", "options": [{"label": "A", "text": "RNA-dependent DNA polymerase inhibition", "correct": false}, {"label": "B", "text": "RNA-dependent RNA polymerase inhibition", "correct": true}, {"label": "C", "text": "Fusion inhibition", "correct": false}, {"label": "D", "text": "Entry inhibition", "correct": false}], "correct_answer": "B. RNA-dependent RNA polymerase inhibition", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - RNA-dependent &lt;span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\"&gt;RNA&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"d419920a6616927771969805c3d65d\"&gt;polymerase&lt;/span&gt; inh\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs used to treat COVID-19</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Remdesivir</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Inhibits RNA-dependent <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Favipiravir</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Molnupiravir</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Causes errors in the <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> during replication</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nirmatrelvir</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Protease inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bebtelovimab</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Monoclonal antibodies against <span class=\"customMeta\" data-dictid=\"1931730fd41692777199bf164f574c\">spike</span> protein of SARS-CoV2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bamlanivimab</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sotrovimab</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tocilizumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>IL-6 inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Baricitinib</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Janus <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Methylprednisolone/dexamethasone.</p>\n<p>Reduction of mortality and inflammation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Heparin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anti-coagulation and prevention of thrombotic complications.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs would enhance the bioavailability of saquinavir?", "options": [{"label": "A", "text": "Ritonavir", "correct": true}, {"label": "B", "text": "Vitamin C", "correct": false}, {"label": "C", "text": "Cimetidine", "correct": false}, {"label": "D", "text": "Ganciclovir", "correct": false}], "correct_answer": "A. Ritonavir", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Ritonavir</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Protease inhibitors (PI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Inhibits the assembly/packaging of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> proteins</li>\n<li>Competitively inhibits the action of <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> <span class=\"customMeta\" data-dictid=\"d8b501495a16927771829f9857080b\">aspartyl</span> protease</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>All are CYP3A4 inhibitors: Except Nelfinavir (CYP2C9)</p>\n<ul>\n<li>Increases <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> of other drugs</li>\n<li>Simvastatin: Risk of myopathy</li>\n<li>Midazolam: Causes <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>HIV treatment and 2nd line Post-exposure prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ritonavir\n\t\t\t\t<ul>\n<li>Maximum CYP <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> → inhibits <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> of other PI</li>\n<li>Low-dose <span class=\"customMeta\" data-dictid=\"dea585d18816927771975072308534\">ritonavir</span> boosts other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors (Lopinavir)</li>\n</ul>\n</li>\n<li>Amprenavir</li>\n<li>Fos-amprenavir</li>\n<li>Tipranavir</li>\n<li>Indinavir</li>\n<li>Saquinavir (least CYP inhibitor)</li>\n<li>Lopinavir</li>\n<li>Atazanavir (no dyslipidemia)</li>\n<li>Nelfinavir</li>\n<li>Darunavir (maximum bioavailability, taken with food)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>P-glycoprotein efflux transporter</li>\n<li>Cross-resistance with other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the likely cause for shifting the initial treatment plan of starting on ampicillin to ceftriaxone in a 14-month-old diagnosed with Haemophilus influenza meningitis?", "options": [{"label": "A", "text": "Haemophilus alters penicillin-binding protein sites, hence resistant to ampicillin.", "correct": false}, {"label": "B", "text": "Easier to administer IV ceftriaxone than IV ampicillin", "correct": false}, {"label": "C", "text": "Cotrimoxazole is the drug of choice, butthe patient is allergic to sulfa drugs", "correct": false}, {"label": "D", "text": "Hemophilus produces beta-lactamase, hence resistant to ampicillin", "correct": true}], "correct_answer": "D. Hemophilus produces beta-lactamase, hence resistant to ampicillin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"dbefd3875e1692777188f7d6c1de89\"&gt;Hemophilus&lt;/span&gt; produces beta-lactamase, hence resistant to ampicillin.</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cell wall <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits transpeptidase (penicillin-binding protein) and prevents cross-linking</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p>1. Penicillin</p>\n<p>2. Cephalosporin</p>\n<p>3. Carbapenems</p>\n<p>4. <strong>Monobactam</strong> (Aztreonam)</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>MSSA infections</li>\n<li>Perioperative prophylaxis</li>\n<li>Syphilis</li>\n<li>Meningitis</li>\n<li>Community-acquired pneumonia</li>\n<li>GI and GU infection</li>\n<li>Aztreonam in <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> allergy.</li>\n<li>Ertapenam in ESBL, P. aeruginosa, and Acinetobacter</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. Hypersensitivity</p>\n<p>2. Cross <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> (except monobactams)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"57a27d06931692777187a88d754b8f\">enol</span> <span class=\"customMeta\" data-dictid=\"f9129e152d16927771960c4ccc40bc\">pyruvate</span> <span class=\"customMeta\" data-dictid=\"2288cbf3741692777200318d2f5b39\">transferase</span> and block <span class=\"customMeta\" data-dictid=\"9859613acd1692777187a2aaacae71\">GAG</span> synthesis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fosfomycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Enterococcal <span class=\"customMeta\" data-dictid=\"210e94f8861692777201a0d6de4b0e\">UTI</span> (Foley's catheter)</li>\n<li>Transurethral procedures</li>\n<li>Safe in pregnancy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. Hematuria</p>\n<p>2. <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">Urinary</span> discomfort</p>\n<p>3. Neuropsychiatric: Psychosis, seizures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>D-alanine <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> inhibits <span class=\"customMeta\" data-dictid=\"7f4e6edbc91692777181c6fa295ae7\">alanine</span> <span class=\"customMeta\" data-dictid=\"8208c3e86b1692777197c49134ede1\">racemase</span> and ligase</p>\n<p>(<strong>Bacteriostatic</strong>)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cycloserine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Multidrug resistant TB</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. Neurotoxicity</p>\n<p>2. Psychosis</p>\n<p>3. Depression (Suicide risk)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits bactoprenol dephosphorylase enzyme</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bacitracin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Topical cream in <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> <span class=\"customMeta\" data-dictid=\"57640139fe169277718418f95ae49f\">cocci</span> (Staphylococcus and Streptococcus) skin infection</li>\n<li>Oral: Enterococcal infection</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"0834e545c9169277719383768d0ff2\">Nephrotoxic</span> (IV)</p>\n<p>2. <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">Bone marrow</span> suppression</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibition of transglucosidase enzyme</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vancomycin</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pseudomembranous colitis(oral)</li>\n<li>MRSA</li>\n<li>E. faecalis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1. Nephrotoxicity</p>\n<p>2. Ototoxicity</p>\n<p>3. Red man syndrome</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A breast cancer patient post-chemotherapy developed a low-grade fever with anemia and leukocytopenia (&amp;lt;4000/cm3; DNC: 30). Which of the following antibiotics will not be used in the empirical management of this patient?", "options": [{"label": "A", "text": "Cefepime", "correct": false}, {"label": "B", "text": "Piperlacillin - Tazobactam", "correct": false}, {"label": "C", "text": "Linezolid", "correct": true}, {"label": "D", "text": "Meropenem", "correct": false}], "correct_answer": "C. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Linezolid</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>MOA</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> of the class oxazolidinones</p>\n<ul>\n<li>Attaches to a site on the bacterial 23S <span class=\"customMeta\" data-dictid=\"ff37e741eb1692777197a5d617b479\">ribosomal RNA</span> of the 50S subunit</li>\n<li>Prevents the formation of a functional 70S <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> complex.</li>\n<li>It mainly acts against <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> organisms</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Skin and skin structure infections by <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">staphylococcus</span> and streptococcus.</li>\n<li>Community-acquired <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> due to <span class=\"customMeta\" data-dictid=\"9562e26acc16927771995a2028dd05\">streptococcus</span> pneumoniae.</li>\n<li>Nosocomial <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> due to <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">staphylococcus</span> aureus.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Adverse effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Inhibits mitochondrial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and may lead to</li>\n</ul>\n<ul>\n<li>Peripheral neuropathy</li>\n<li>Optic neuritis</li>\n<li>Lactic <span class=\"customMeta\" data-dictid=\"6caf3a39f416927771807e122b9032\">acidosis</span> in patients receiving the drug for longer durations.</li>\n</ul>\n<ul>\n<li>Serotonin syndrome when coadministered with <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> or <span class=\"customMeta\" data-dictid=\"ff0f0a7e341692777198133f3861c7\">serotonergic</span> drugs like SSRIs due to its <span class=\"customMeta\" data-dictid=\"70d4f989c31692777193372189cfbb\">nonspecific</span> <span class=\"customMeta\" data-dictid=\"0307bca2ef1692777191b7df13d4b3\">MAO</span> inhibition.</li>\n<li>Linezolid can cause myelosuppression, which can present as</li>\n</ul>\n<ul>\n<li>Anemia</li>\n<li>Thrombocytopenia</li>\n<li>Leukopenia</li>\n<li>Sometimes pancytopenia.</li>\n<li>It usually occurs 7-10 days after administration of the drug and is usually reversed on discontinuation of the drug.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who was on warfarin therapy for atrial fibrillation is prescribed a Cephalosporin for the treatment of a lower respiratory tract infection. He comes back to the hospital after having developed hemarthrosis. Which of the following cephalosporins is likely to have caused this?", "options": [{"label": "A", "text": "Cefixime", "correct": false}, {"label": "B", "text": "Cefoperazone", "correct": true}, {"label": "C", "text": "Ceftobiprole", "correct": false}, {"label": "D", "text": "Ceftazidime", "correct": false}], "correct_answer": "B. Cefoperazone", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"5\" rowspan=\"1\">\n<p>Cephalosporin and its uses</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>1st gen</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>2nd gen</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>3rd gen</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>4th gen</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>5th gen</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Cephazolin</p>\n<p>Cephalexin</p>\n<p>Cefadroxil</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Cefuroxime</p>\n<p>Cefoxitin</p>\n<p>Cefaclor</p>\n<p>Cefprozil</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Cefotaxime</p>\n<p>Ceftizoxime</p>\n<p>Ceftriaxone</p>\n<p>Ceftazidime</p>\n<p>Cefpodoxime proxetil</p>\n<p>Cefdinir</p>\n<p>Ceftibuten</p>\n<p>Ceftamet pivoxil</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Cefepime</p>\n<p>Cefpirome</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Ceftaroline</p>\n<p>Ceftobiprole</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>First generation</p>\n</td>\n<td colspan=\"4\" rowspan=\"1\">\n<ul>\n<li>ENT, upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> &amp; <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> infections</li>\n<li>Surgical prophylaxis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Second generation</p>\n</td>\n<td colspan=\"4\" rowspan=\"1\">\n<ul>\n<li>Mixed aerobic-anaerobic infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p> </p>\n<p> </p>\n<p>Third generation</p>\n</td>\n<td colspan=\"4\" rowspan=\"1\">\n<ul>\n<li>Ceftriaxone/Cefotaxime: <span class=\"customMeta\" data-dictid=\"95c41bced21692777187fa909c1937\">empirical</span> therapy for meningitis</li>\n<li>Ceftazidime: <span class=\"customMeta\" data-dictid=\"dea08f9dd81692777196a5f62e6862\">Pseudomonas</span> meningitis</li>\n<li>STI : Gonorrhea, chancroid, syphilis</li>\n<li>Enteric fever</li>\n<li>Patients with neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Fourth generation</p>\n</td>\n<td colspan=\"4\" rowspan=\"1\">\n<ul>\n<li>Nosocomial infections (intensive care borne)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p> </p>\n<p>Fifth generation</p>\n</td>\n<td colspan=\"4\" rowspan=\"1\">\n<ul>\n<li>Penicillin resistant community <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> and hospital-acquired <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> by S.pneumoniae</li>\n<li>Penicillinase-producing S.aureus infections</li>\n<li>MRSA</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following steps does Vancomycin act on?", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "4", "correct": true}], "correct_answer": "D. 4", "question_images": ["https://image.prepladder.com/content/VCOXilOmLXD2ekPvCXNg1747131232.png"], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Vancomycin </p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>MOA</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Cell wall <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitor</p>\n<p>Binds to the D-alanyl-D-alanine portion of peptidoglycan, which inhibits transglycosylase enzyme and reduces further <span class=\"customMeta\" data-dictid=\"3e53f6980f1692777187044dd3f9e7\">elongation</span> of <span class=\"customMeta\" data-dictid=\"8d8d5e23f3169277719592e0c8d2b4\">peptidoglycan</span> and <span class=\"customMeta\" data-dictid=\"2cf4952c63169277718543a0883583\">cross-linking</span> during</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Bactericidal agent against Gram +ve bacteria</p>\n<ul>\n<li>Pseudomembranous colitis(oral)</li>\n<li>MRSA</li>\n<li>E. faecalis</li>\n<li>Enterococcal <span class=\"customMeta\" data-dictid=\"33812b7bb0169277718707b5473b45\">endocarditis</span> (Alternative therapy)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Resistance</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Seen in enterococci - due to alteration in its binding side where D-ala is replaced by D-lactate</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Adverse effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Nephrotoxicity</li>\n<li>Ototoxicity</li>\n<li>Red man syndrome</li>\n<li>Phlebitis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following diseases does not involve the use of antimicrobial combinations?", "options": [{"label": "A", "text": "Uncomplicated gonorrhea", "correct": true}, {"label": "B", "text": "Tuberculosis", "correct": false}, {"label": "C", "text": "Intra-abdominal infections", "correct": false}, {"label": "D", "text": "Malaria", "correct": false}], "correct_answer": "A. Uncomplicated gonorrhea", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug would be considered safe for use in a pregnant woman at 20 weeks gestation presenting with fever and dysuria and preliminarily diagnosed with cystitis?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Gentamicin", "correct": false}, {"label": "C", "text": "Cotrimoxazole", "correct": false}, {"label": "D", "text": "Amoxicillin", "correct": true}], "correct_answer": "D. Amoxicillin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D. \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding foscarnet is false?", "options": [{"label": "A", "text": "It is used for resistant CMV", "correct": false}, {"label": "B", "text": "Renal toxicity is seen", "correct": false}, {"label": "C", "text": "It is activated by viral thymidine kinase", "correct": true}, {"label": "D", "text": "Regular monitoring of serum electrolytes is required", "correct": false}, {"label": "E", "text": "It can cause genital ulceration", "correct": false}], "correct_answer": "C. It is activated by viral thymidine kinase", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is not true about the management of a nurse who experienced an accidental needle prick from an HIV-infected needle?", "options": [{"label": "A", "text": "Zidovudine is used as monotherapy in post exposure prophylaxis", "correct": true}, {"label": "B", "text": "Washing hands with soap and water is advised", "correct": false}, {"label": "C", "text": "Baseline viral markers of healthcare personnel should be done at the time of prick", "correct": false}, {"label": "D", "text": "Follow up viral markers of healthcare personnel should be measure at 6 weeks", "correct": false}, {"label": "E", "text": "Tenofovir + Lamivudine + Efavirenz for a period of 4 weeks", "correct": false}], "correct_answer": "A. Zidovudine is used as monotherapy in post exposure prophylaxis", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p>Zidovudine (AZT)</p>\n</td>\n<td>\n<p>Used as part of a combination therapy (usually with <span class=\"customMeta\" data-dictid=\"548c02a1cf1692777191e70df694f8\">lamivudine</span> and a <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitor) for post-exposure <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> (PEP) against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lamivudine</p>\n</td>\n<td>\n<p>Used in combination with other <span class=\"customMeta\" data-dictid=\"4019cd26841692777181fa4c0c5a6a\">antiretroviral</span> drugs for <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tenofovir disoproxil <span class=\"customMeta\" data-dictid=\"0063169a1b1692777203ba89eb2363\">fumarate</span> (TDF)</p>\n</td>\n<td>\n<p>Used in combination with other <span class=\"customMeta\" data-dictid=\"4019cd26841692777181fa4c0c5a6a\">antiretroviral</span> drugs for <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ritonavir-boosted lopinavir</p>\n</td>\n<td>\n<p>Used in combination with other <span class=\"customMeta\" data-dictid=\"4019cd26841692777181fa4c0c5a6a\">antiretroviral</span> drugs for <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Emtricitabine (FTC)</p>\n</td>\n<td>\n<p>Used in combination with other <span class=\"customMeta\" data-dictid=\"4019cd26841692777181fa4c0c5a6a\">antiretroviral</span> drugs for <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Efavirenz</p>\n</td>\n<td>\n<p>Used in combination with other <span class=\"customMeta\" data-dictid=\"4019cd26841692777181fa4c0c5a6a\">antiretroviral</span> drugs for <span class=\"customMeta\" data-dictid=\"624ee3cb8d1692777195f4dce9b626\">PEP</span> against HIV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Baseline <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> Markers</p>\n</td>\n<td>\n<p>Testing for <span class=\"customMeta\" data-dictid=\"3c8a051a89169277718256c92278c5\">baseline</span> <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> load and <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> antibodies of the healthcare worker at the time of the needle prick</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Follow-up <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">Viral</span> Markers</p>\n</td>\n<td>\n<p>Testing for <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> load and <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> antibodies of the healthcare worker at 6 weeks and 3 months post-exposure</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Counselling and Psychological Support</p>\n</td>\n<td>\n<p>Providing emotional support, counselling, and education regarding <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> transmission and prevention</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which medical conditions is Tafenoquine used?", "options": [{"label": "A", "text": "Radical cure of plasmodium", "correct": true}, {"label": "B", "text": "Prophylaxis of malaria in pregnancy", "correct": false}, {"label": "C", "text": "Treatment of severe falciparum malaria", "correct": false}, {"label": "D", "text": "Treatment of malaria in children &amp;lt;2 years", "correct": false}], "correct_answer": "A. Radical cure of plasmodium", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended medication for treating a 23-year-old female who is experiencing burning pain while urinating and has been diagnosed with a co-infection of chlamydia and gonococcus?", "options": [{"label": "A", "text": "Azithromycin", "correct": true}, {"label": "B", "text": "Ceftriaxone", "correct": false}, {"label": "C", "text": "Fluconazole", "correct": false}, {"label": "D", "text": "Clindamycin", "correct": false}], "correct_answer": "A. Azithromycin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred medication for preventing meningococcal meningitis in a pregnant woman following exposure to a confirmed case?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Ceftriaxone", "correct": true}, {"label": "C", "text": "Cefalexin", "correct": false}, {"label": "D", "text": "Rifabutin", "correct": false}], "correct_answer": "B. Ceftriaxone", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Antibiotic</strong></p>\n</td>\n<td>\n<p><strong>Dosage</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ceftriaxone</p>\n</td>\n<td>\n<p>250 mg <span class=\"customMeta\" data-dictid=\"8a99f9c37f16927771902daa814697\">intramuscular</span> (IM) or <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> (IV) once</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Cefotaxime</p>\n</td>\n<td>\n<p>1 g <span class=\"customMeta\" data-dictid=\"8a99f9c37f16927771902daa814697\">intramuscular</span> (IM) or <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> (IV) once</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Penicillin G</p>\n</td>\n<td>\n<p>2 million units <span class=\"customMeta\" data-dictid=\"8a99f9c37f16927771902daa814697\">intramuscular</span> (IM) once</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Azithromycin</p>\n</td>\n<td>\n<p>1 g orally once</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Rifampin</p>\n</td>\n<td>\n<p>600 mg orally twice daily for 2 days</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In fungi, where does amphotericin B primarily exert its effects?", "options": [{"label": "A", "text": "Nucleic acid", "correct": false}, {"label": "B", "text": "Ribosome", "correct": false}, {"label": "C", "text": "Cell membrane", "correct": true}, {"label": "D", "text": "Cytoplasm", "correct": false}], "correct_answer": "C. Cell membrane", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which antiviral drug possesses dual antiviral activity against both HIV and HBV?", "options": [{"label": "A", "text": "Enfuvirtide", "correct": false}, {"label": "B", "text": "Abacavir", "correct": false}, {"label": "C", "text": "Tenofovir", "correct": true}, {"label": "D", "text": "Ritonavir", "correct": false}], "correct_answer": "C. Tenofovir", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Tenofov\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the aerosol medication that is administered to children for the treatment of RSV infection?", "options": [{"label": "A", "text": "Indinavir", "correct": false}, {"label": "B", "text": "Amantadine", "correct": false}, {"label": "C", "text": "Ribavirin", "correct": true}, {"label": "D", "text": "Tenofovir", "correct": false}], "correct_answer": "C. Ribavirin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C.\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Praziquantel is utilized to treat which medical condition?", "options": [{"label": "A", "text": "Strongyloidiasis", "correct": false}, {"label": "B", "text": "Trichomoniasis", "correct": false}, {"label": "C", "text": "Schistosomiasis", "correct": true}, {"label": "D", "text": "Rhinosporidiosis", "correct": false}], "correct_answer": "C. Schistosomiasis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Cestodes</strong></p>\n</td>\n<td>\n<p><strong>Drug of choice</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tenia solium</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Taenia sagginata</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Fish tapeworm</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>H. nana</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Neurocysticerocis</p>\n<p>And <span class=\"customMeta\" data-dictid=\"cc96ad6655169277718944f7ffe9ae\">Hydatid</span> cyst</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Nematodes</strong></p>\n</td>\n<td>\n<p><strong>Drug of choice</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ascaris Lumbricoides</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Ancylostoma Duodenale</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Necator Americans</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Enterobius Vemicularis (Pin Worm)</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Trichenella spiralis</p>\n</td>\n<td>\n<p>Albendazole</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Filariasis</p>\n</td>\n<td>\n<p>Diethyl Carbamazine (DEC)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Loa Loa</p>\n</td>\n<td>\n<p>Diethyl Carbamazine (DEC)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Strongyloidosis</p>\n</td>\n<td>\n<p>Ivermectin</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Trematodes (Flukes )</strong></p>\n</td>\n<td>\n<p><strong>Drug of choice</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Blood fluke</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lung fluke</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bladder fluke</p>\n</td>\n<td>\n<p>Praziquantel</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Liver <span class=\"customMeta\" data-dictid=\"61cf8cf31116927772021c5d12d815\">fluke</span> (Fasciola hepatica)</p>\n</td>\n<td>\n<p>Triclabendazole</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Pretomanid is used in the treatment of which condition?", "options": [{"label": "A", "text": "MDR TB", "correct": true}, {"label": "B", "text": "Malaria", "correct": false}, {"label": "C", "text": "Fungal Infections", "correct": false}, {"label": "D", "text": "Leprosy", "correct": false}], "correct_answer": "A. MDR TB", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Delamanid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of mycolic acid by <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> production, an essential component of the <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> of M.tuberculosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea, vomiting, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, headache, and elevated liver enzymes.</li>\n<li><strong>QT prolongation</strong>, which can increase the risk of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias</li>\n<li>Monitoring of liver function and <span class=\"customMeta\" data-dictid=\"40ebcbf95e169277718613d7c2d999\">ECG</span> is recommended during treatment</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pretomanid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibiting the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of mycolic acid by disrupting the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids in the <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> of M.tuberculosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea, vomiting, and diarrhea</li>\n<li>Peripheral neuropathy</li>\n<li>Hepatotoxicity</li>\n<li>Acne</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:706px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Second-line ATT drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Group A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Group B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Group C</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bedaquilin</li>\n<li>Levofloxacin or Moxifloxacin</li>\n<li>Linezolid</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cycloserine</li>\n<li>Clofazimine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Delamanid</li>\n<li>Amikacin</li>\n<li>Meropenem or Imipenem-cilastatin</li>\n<li>PAS</li>\n<li>Ethionamide</li>\n<li>Ethambutol</li>\n<li>Pyrazinamide</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In an individual traveling to an area with endemic malaria, which of the following is the preferred chemoprophylaxis option?", "options": [{"label": "A", "text": "Chloroquine", "correct": true}, {"label": "B", "text": "Quinine", "correct": false}, {"label": "C", "text": "Lumefantrine", "correct": false}, {"label": "D", "text": "Pyrimethamine", "correct": false}], "correct_answer": "A. Chloroquine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the clinical application of tafenoquine among the options provided?", "options": [{"label": "A", "text": "Radical cure of Plasmodium vivax", "correct": true}, {"label": "B", "text": "Prophylaxis of malaria in pregnancy", "correct": false}, {"label": "C", "text": "Treatment of severe falciparum malaria", "correct": false}, {"label": "D", "text": "Treatment of malaria in children &amp;lt;2 years", "correct": false}], "correct_answer": "A. Radical cure of Plasmodium vivax", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A.\n<table>\n<thead>\n<tr>\n<td>\n<p><strong>Clinical Use</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Radical cure of <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">Plasmodium</span> vivax</p>\n</td>\n<td>\n<p>Tafenoquine is used for the radical cure of <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">Plasmodium</span> vivax malaria. It is administered in combination with a blood <span class=\"customMeta\" data-dictid=\"bcb3825161169277719816978b1bd9\">schizonticide</span> to treat the <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> infection and to prevent <span class=\"customMeta\" data-dictid=\"b4b361c37616927771979541177070\">relapse</span> by eliminating the <span class=\"customMeta\" data-dictid=\"ea2c7a14ba1692777186a074b34ee8\">dormant</span> liver stages (hypnozoites) of the parasite.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Prophylaxis of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> in pregnancy</p>\n</td>\n<td>\n<p>Tafenoquine may be used for the <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> in pregnant women, particularly in areas where <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">Plasmodium</span> vivax is prevalent. However, its use in pregnancy requires careful consideration and should be determined by a healthcare professional based on the individual's risk-benefit profile.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Treatment of severe falciparum malaria</p>\n</td>\n<td>\n<p>Tafenoquine is not typically used as a first-line treatment for severe falciparum malaria. Other <span class=\"customMeta\" data-dictid=\"7f56a9f82e1692777181c7810a4c8b\">antimalarial</span> medications, such as <span class=\"customMeta\" data-dictid=\"9548b5ab1a16927771825a704230b7\">artesunate</span> or quinine, are commonly used in combination with other drugs for the treatment of severe malaria.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"8b4c650ddd1692777191286afbcd8a\">malaria</span> in children &lt;2 years</p>\n</td>\n<td>\n<p>Tafenoquine is not approved for use in children under the age of 18 years, including children younger than 2 years. Its safety and <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> in <span class=\"customMeta\" data-dictid=\"318e52e4751692777195acbcdf4551\">pediatric</span> populations have not been well established.</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the incorrect statement in relation to antiviral medications:", "options": [{"label": "A", "text": "Ombitasvir prevents HCV protein synthesis", "correct": true}, {"label": "B", "text": "Imiquimod used in treatment of condyloma acuminata", "correct": false}, {"label": "C", "text": "Simprevir inhibits protease of hepatitis C", "correct": false}, {"label": "D", "text": "Oseltamivir is used for swine flu", "correct": false}], "correct_answer": "A. Ombitasvir prevents HCV protein synthesis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A.\n<table>\n<thead>\n<tr>\n<td>\n<p><strong>Antiviral</strong></p>\n</td>\n<td>\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td>\n<p><strong>Clinical Uses</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Ombitasvir</p>\n</td>\n<td>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"ea263cfb7716927771886ad52146e0\">HCV</span> NS5A protein</p>\n</td>\n<td>\n<p>Treatment of chronic <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> C</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Imiquimod</p>\n</td>\n<td>\n<p>Enhances immune response</p>\n</td>\n<td>\n<p>Treatment of external <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> and <span class=\"customMeta\" data-dictid=\"fb89fe7db116927771957d22da5a71\">perianal</span> warts, <span class=\"customMeta\" data-dictid=\"8e97b73dae1692777180afeb1d2e50\">actinic</span> keratosis, and <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cell carcinoma</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Simeprevir</p>\n</td>\n<td>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"ea263cfb7716927771886ad52146e0\">HCV</span> NS3/4A protease</p>\n</td>\n<td>\n<p>Treatment of chronic <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> C</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Oseltamivir</p>\n</td>\n<td>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">influenza</span> virus neuraminidase</p>\n</td>\n<td>\n<p>Treatment and <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of <span class=\"customMeta\" data-dictid=\"c3817918b816927771902d2176d0c8\">influenza</span> A and B</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Foscarnet</p>\n</td>\n<td>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA polymerase</p>\n</td>\n<td>\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"ee831318721692777185479e65655e\">cytomegalovirus</span> (CMV) infections, particularly in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tafenoquine</p>\n</td>\n<td>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">Plasmodium</span> vivax relapse</p>\n</td>\n<td>\n<p>Radical cure of <span class=\"customMeta\" data-dictid=\"adb1d6aae2169277719562770dd578\">Plasmodium</span> vivax malaria</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Assertion: Larger doses of acyclovir are recommended for treatment of genital herpes in HIV positive patients Reason: Frequent recurrences of genital herpes is seen in HIV patients", "options": [{"label": "A", "text": "Both assertion and reason are true and reason is correct explanation for the assertion", "correct": true}, {"label": "B", "text": "Both assertion and reason are true and reason is not the correct explanation for the assertion", "correct": false}, {"label": "C", "text": "Assertion is true, but the reason is false", "correct": false}, {"label": "D", "text": "Assertion is false, but the reason is true", "correct": false}, {"label": "E", "text": "Both assertion and reason are false", "correct": false}], "correct_answer": "A. Both assertion and reason are true and reason is correct explanation for the assertion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A.\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female presented with burning micturition and symptoms of UTI. Which of the following fluoroquinolones is least likely to be effective if UTI is caused by Enterococcus species?", "options": [{"label": "A", "text": "Ofoxacin", "correct": false}, {"label": "B", "text": "Cirpofloxacin", "correct": false}, {"label": "C", "text": "Moxifloxacin", "correct": true}, {"label": "D", "text": "Levofloxacin", "correct": false}], "correct_answer": "C. Moxifloxacin", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/IB5QulHfgA8BFkwUZwh51747987469.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fluoroquinolones</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>First Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Second Generation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Norfloxacin</li>\n<li>Ciprofloxacin <strong>(Option B)</strong></li>\n<li>Ofloxacin <strong>(Option A)</strong></li>\n<li>Pefloxacin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Sparfloxacin</li>\n<li>Levofloxacin <strong>(Option D)</strong></li>\n<li>Moxifloxacin <strong>(Option C)</strong></li>\n<li>Gemifloxacin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Moderate half-life</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Longer half-life</li>\n<li>Better tissue penetration</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit bacterial <strong>DNA gyrase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit bacterial<strong> DNA gyrase</strong> and <strong>topoisomerase IV</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"PPH047 MOA of Fluoroquinolones\" data-author=\"NA\" data-hash=\"13247\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/IB5QulHfgA8BFkwUZwh51747987469.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spectrum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Effective against Gram-negative bacteria</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Broader spectrum, including Gram (+ve), Gram (-ve) and Atypical pathogens.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Prostatitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Respiratory infections</li>\n<li>Skin infections</li>\n<li>Complicated UTIs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Diarrhea</li>\n<li>Dizziness</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>QT prolongation</li>\n<li>Tendonitis</li>\n<li>CNS effects</li>\n<li>Phototoxicity</li>\n<li>Peripheral neuropathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pregnancy</li>\n<li>Children</li>\n<li>Myasthenia gravis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Same as the first-generation</li>\n<li>Patients with <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female patient presented with burning micturition. A diagnosis of cystitis was made. Which of the following drugs will be used for treatment?", "options": [{"label": "A", "text": "Amoxycillin", "correct": false}, {"label": "B", "text": "TMP-SMX", "correct": true}, {"label": "C", "text": "Ciprofloxacin", "correct": false}, {"label": "D", "text": "Doxycycline", "correct": false}], "correct_answer": "B. TMP-SMX", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - TMP-SMX is the first-line treatment for uncomplicated cystitis.</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Trimethoprim-sulfamethoxazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Trimethoprim (TMP)</strong>: Inhibits <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">dihydrofolate</span> reductase, <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the conversion of <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">dihydrofolate</span> acid to tetrahydrofolic acid</p>\n<p><strong>Sulfamethoxazole (SMX)</strong>: Inhibits dihydropteroate synthase, preventing the <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">incorporation</span> of <span class=\"customMeta\" data-dictid=\"2840845b5b16927771946abe018ef6\">para-aminobenzoic acid</span> (PABA) into dihydropteroic acid, an essential <span class=\"customMeta\" data-dictid=\"ae13cdc5c3169277719683e9f6bda5\">precursor</span> in <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> synthesis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections (DOC for mild cases)</li>\n<li>Respiratory <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>GIT Infections</li>\n<li>Prevention and treatment of Pneumocystis jirovecii <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> in <span class=\"customMeta\" data-dictid=\"a3cc9f976916927771895692a1a8a0\">immunocompromised</span> patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Diarrhoea</li>\n<li>Rash</li>\n<li>Hypersensitivity reactions (including Stevens-Johnson syndrome and toxic <span class=\"customMeta\" data-dictid=\"616d85c57416927771875ef23f6751\">epidermal</span> necrolysis)</li>\n<li>Blood dyscrasias (e.g., neutropenia, thrombocytopenia)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Note</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Contraindicated in patients with <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> deficiency</li>\n<li>Use with caution in pregnant women, infants, and individuals with G6PD deficiency</li>\n<li>Increased risk of <span class=\"customMeta\" data-dictid=\"8bf09336411692777189d1a79bf6a5\">hyperkalemia</span> with potassium-sparing diuretics</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the drug of choice for UTI in pregnancy?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Azithromycin", "correct": false}, {"label": "C", "text": "Clarithromycin", "correct": false}, {"label": "D", "text": "Ceftriaxone", "correct": true}], "correct_answer": "D. Ceftriaxone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Ceftriaxone</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses of cephalosporins</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>First generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>ENT, upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> &amp; <span class=\"customMeta\" data-dictid=\"94f1c8df1f1692777185bd6a7c3fff\">cutaneous</span> infections</li>\n<li>Surgical prophylaxis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Second generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mixed aerobic-anaerobic infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p><strong>Third generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Empirical therapy for meningitis</li>\n<li>Pseudomonas meningitis</li>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection in pregnancy</li>\n<li>STI : Gonorrhea, chancroid, syphilis</li>\n<li>Enteric fever</li>\n<li>Patients with neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fourth generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nosocomial infections (intensive care borne)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Fifth generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Penicillin-resistant <span class=\"customMeta\" data-dictid=\"d7ccdaffea1692777184e4c19a10aa\">community-acquired</span> and hospital-acquired <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> by S.pneumoniae</li>\n<li>Penicillinase-producing S.aureus infections</li>\n<li>MRSA</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male came to the emergency department after sustaining a fall. X-ray showed a fractured neck of the femur and was operated on for the same. On postoperative day 2, he experienced a sharp, severe, constant burning pain over his right back. On examination, the lesion is as seen below. The area is tender to light touch, with a rash over the area. What is the most appropriate treatment for this patient?", "options": [{"label": "A", "text": "Amitriptyline", "correct": false}, {"label": "B", "text": "Topical steroid", "correct": false}, {"label": "C", "text": "Valacyclovir", "correct": true}, {"label": "D", "text": "Mupirocin", "correct": false}], "correct_answer": "C. Valacyclovir", "question_images": ["https://image.prepladder.com/content/BKRgp6Dm2XNTY7Av0VNt1746696785.png"], "explanation_images": ["https://image.prepladder.com/notes/BZJSQP9BJwPhraqhYlnc1747987219.png"], "explanation": "<p>Correct Answer C - Valacyclovir:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Valacyclovir</strong> (a <span class=\"customMeta\" data-dictid=\"1c0d8a64fa1692777196f90166732c\">prodrug</span> of acyclovir)</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"PPH051 Valacyclovir MOA\" data-author=\"NA\" data-hash=\"13245\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/BZJSQP9BJwPhraqhYlnc1747987219.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Varicella <span class=\"customMeta\" data-dictid=\"03350c16f71692777202dbca70976e\">zoster</span> virus (VZV) - Most effective</p>\n<p>Epstein Barr virus</p>\n<p>Herpes simplex virus-1 and 2</p>\n<ul>\n<li>Genital herpes</li>\n<li>Mucocutaneous <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> simplex (use IV)</li>\n<li>Herpes labialis, Keratoconjunctivitis (use topical)</li>\n<li>HSV <span class=\"customMeta\" data-dictid=\"9644652a1f16927771873765457fcc\">encephalitis</span> (use IV)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Associated with <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> <span class=\"customMeta\" data-dictid=\"e32083bfa81692777200f1407487aa\">thymidine</span> <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> mutation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thrombocytopenia</p>\n<p>Neurotoxicity: seizures, confusion, hallucinations</p>\n<p>Nephrotoxicity: Obstructive <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure (crystalluria)</p>\n<ul>\n<li>Contraindicated with <span class=\"customMeta\" data-dictid=\"fa041055ec16927771858fe49c76d3\">cyclosporine</span> and probenecid</li>\n<li>Administer plenty of IV fluid and water</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the required dose adjustment in a person who started anti-tubercular therapy and is already on ART therapy with Tenofovir 200 mg, Dolutegravir 100 mg at night, and Lamivudine 200 mg?", "options": [{"label": "A", "text": "Add tenofovir 200 mg in the morning", "correct": false}, {"label": "B", "text": "Add dolutegravir 100 mg in the morning", "correct": true}, {"label": "C", "text": "No dose adjustment", "correct": false}, {"label": "D", "text": "Add lamivudine 200 mg in the morning", "correct": false}], "correct_answer": "B. Add dolutegravir 100 mg in the morning", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient in the emergency has the following lab parameters: creatinine 1.5 and BUN 45. The chest x-ray (pneumonia with infiltrates in the middle part of the right lung and patchy infiltrates in the left lung) is given. In gram staining and culture, only rhinovirus was isolated. The patient is shifted to the ICU. What is the best treatment of choice in this option?", "options": [{"label": "A", "text": "Azithrymycin", "correct": false}, {"label": "B", "text": "Amoxicillin + Clavulanic acid", "correct": false}, {"label": "C", "text": "Piptaz + Ciprofloxacin", "correct": false}, {"label": "D", "text": "Ceftriaxone + Azithromycin", "correct": true}], "correct_answer": "D. Ceftriaxone + Azithromycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Ceftriaxone + Azithromycin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>CURB-65</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Symptom</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Score</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>(<strong>C</strong>) Confusion</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>(<strong>U</strong>) Urea: <span class=\"customMeta\" data-dictid=\"eeb0ec7e661692777183f957a8794b\">BUN</span> &gt;19mg/dL (&gt;7 mmol/L)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>(<strong>R</strong>) <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">Respiratory</span> rate ≥30/min</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>(<strong>B</strong>) <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">Blood Pressure</span> – <span class=\"customMeta\" data-dictid=\"cf69f5256416927771991c21f264ae\">Systolic</span> BP ≤90 mmHg or diastolic BP ≤60 mmHg</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>(<strong>65</strong>) Age ≥65 years</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For vancomycin dosage, which nomogram scale is employed?", "options": [{"label": "A", "text": "Hallstead scale", "correct": false}, {"label": "B", "text": "Salazar scale", "correct": false}, {"label": "C", "text": "Rumack Matthew nomogram", "correct": false}, {"label": "D", "text": "Matzke scale", "correct": true}], "correct_answer": "D. Matzke scale", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Matzk\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the preferred treatment for Plasmodium falciparum malaria?", "options": [{"label": "A", "text": "Chloroquine", "correct": false}, {"label": "B", "text": "Artemisinin-based combination therapy (ACT)", "correct": true}, {"label": "C", "text": "Primaquine", "correct": false}, {"label": "D", "text": "Doxycycline", "correct": false}], "correct_answer": "B. Artemisinin-based combination therapy (ACT)", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Plasmodium vivax or ovale</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Plasmodium falciparum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mixed infection </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Chloroquine + Primaquine</strong></p>\n<ul>\n<li>Chloroquine 25 mg for 3 days as 10 mg/kg on day 1, 10 mg/kg on day 2 and 5 mg/kg on day 3.</li>\n<li>Primaquine 0.25 mg/kg body wt for 14 days</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Primaquine + ACT</strong></p>\n<ul>\n<li><strong>ACT (Artemisinin-based combination therapy):</strong>\n<ul>\n<li><strong>All Indian states (except northeastern):</strong> Artesunate (4 mg/kg body weight) + <span class=\"customMeta\" data-dictid=\"de9710a9f1169277719972667f51f1\">sulfadoxine</span> (25 mg/kg body weight) or <span class=\"customMeta\" data-dictid=\"1ddf70d55216927771960074a8225c\">pyrimethamine</span> (1.25 mg/kg body weight)</li>\n<li><strong>Northeastern states:</strong> Artemether (20 mg) + Lumefantrine (120 mg)</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>ACT+ Primaquine 0.25 mg per kg body weight daily for 14 days</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug can be used to treat both HIV and Hepatitis B?", "options": [{"label": "A", "text": "Dolutegravir", "correct": false}, {"label": "B", "text": "Tenofovir", "correct": true}, {"label": "C", "text": "Zidovudine", "correct": false}, {"label": "D", "text": "Ritonavir", "correct": false}], "correct_answer": "B. Tenofovir", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tenofovir (Nucleotide <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> RTI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>No <span class=\"customMeta\" data-dictid=\"619ba5e99c16927771958308fb8687\">phosphorylation</span> is required (Option A)</strong></li>\n<li>Competitively inhibits <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> reverse transcriptase</li>\n<li>Incorporates into HIV DNA, causing chain <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">termination</span> (due to incomplete <span class=\"customMeta\" data-dictid=\"387285772b16927771979217d6cd30\">ribose</span> ring)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Tenofovir disoproxil: short-acting, more side effects</li>\n<li>Tenofovir alafenamide: long-acting</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>DOC for HIV</li>\n<li>DOC for Hepatitis B virus + HIV</li>\n<li>HIV pre-exposure <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> (in combination with emtricitabine)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nephrotoxic (Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure)\n\t\t\t\t<ul>\n<li>Regular <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> and <span class=\"customMeta\" data-dictid=\"bfea0730ac16927771959eb551740f\">phosphorus</span> monitoring.</li>\n<li>Avoid with NSAIDs</li>\n</ul>\n</li>\n<li>Fanconi syndrome (causes damage to PCT of nephron)\n\t\t\t\t<ul>\n<li>Leads to <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> loss</li>\n<li>Hypophosphatemic rickets, osteoporosis</li>\n</ul>\n</li>\n<li>Hepatitis B <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> with abrupt discontinuation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Renal disease (High creatinine)\n\t\t\t\t<ul>\n<li>Replace <span class=\"customMeta\" data-dictid=\"8ed4f962f416927772008ece0f551e\">tenofovir</span> with Zidovudine or Abacavir</li>\n</ul>\n</li>\n<li>Child &lt; 10 years</li>\n<li>Weight &lt; 30 kg</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is false about voriconazole?", "options": [{"label": "A", "text": "It should be taken on an empty stomach", "correct": false}, {"label": "B", "text": "It requires therapeutic drug monitoring", "correct": false}, {"label": "C", "text": "It should not be co-administered with pyrazinamide", "correct": true}, {"label": "D", "text": "It requires a loading dose.", "correct": false}], "correct_answer": "C. It should not be co-administered with pyrazinamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - It should not be co-administered with\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following anti-leprosy drugs can cause skin hyperpigmentation?", "options": [{"label": "A", "text": "Clofazimine", "correct": true}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Dapsone", "correct": false}, {"label": "D", "text": "Ofloxacin", "correct": false}], "correct_answer": "A. Clofazimine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A chronic alcoholic patient with alcoholic liver disease was given some anti-amoebic drugs. Later, the patient presented with nausea, vomiting, flushing and hypotension. What is the likely diagnosis", "options": [{"label": "A", "text": "Delirium tremens", "correct": false}, {"label": "B", "text": "Alcohol withdrawal", "correct": false}, {"label": "C", "text": "Disulfiram like reaction", "correct": true}, {"label": "D", "text": "Hallucinosis", "correct": false}], "correct_answer": "C. Disulfiram like reaction", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is ECG change associated with the use of anti-tubercular drug bedaquiline?", "options": [{"label": "A", "text": "QT interval prolongation", "correct": true}, {"label": "B", "text": "PR interval prolongation", "correct": false}, {"label": "C", "text": "QRS widening", "correct": false}, {"label": "D", "text": "ST-segment elevation", "correct": false}], "correct_answer": "A. QT interval prolongation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bedaquiline</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It inhibits <strong>mycobacterial ATP synthase</strong>, a crucial <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> involved in the energy production of Mycobacterium tuberculosis. By disrupting this process, <span class=\"customMeta\" data-dictid=\"d0a85225e8169277718252304cfc4b\">bedaquiline</span> effectively kills the bacteria.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cross-resistance is seen with <strong>clofazimine.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is metabolised by <strong>CYP3A4. </strong>Hence, rifampicin, a CYP3A4 inducer, reduces its efficacy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and diarrhoea (common side effects)</li>\n<li>QT prolongation</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient, after consuming alcohol, started experiencing vomiting, abdominal pain, and chest pain on examination. The patient was hypotensive. What is the drug causing these symptoms?", "options": [{"label": "A", "text": "Cefoperazone", "correct": true}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Calcium channel blockers", "correct": false}, {"label": "D", "text": "Pantoprazole", "correct": false}], "correct_answer": "A. Cefoperazone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Patients receiving which of the following antimicrobial drugs are least likely to develop seizures?", "options": [{"label": "A", "text": "Beta-lactam compounds", "correct": false}, {"label": "B", "text": "Quinolones", "correct": false}, {"label": "C", "text": "Macrolides", "correct": true}, {"label": "D", "text": "Isoniazid", "correct": false}], "correct_answer": "C. Macrolides", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-tubercular drugs is associated with visual disturbances?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Streptomycin", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": true}], "correct_answer": "D. Ethambutol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ethambutol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <strong>arabinosyl transferases</strong> involved in arabinogalactan synthesis, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in cell wall</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mutation of <strong>embAB genes, </strong>which encodes the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <strong>arabinosyl transferase,</strong> reducing its <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In the treatment of</p>\n<ul>\n<li>Mycobacterium tuberculosis</li>\n<li>Mycobacterium avium complex (MAC)</li>\n<li>Mycobacterium kansasii</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Painless loss of vision\n\t\t\t\t<ul>\n<li>Field defects due to <strong>retrobulbar neuritis</strong></li>\n<li>Loss of visual acuity</li>\n<li><strong>Red-green colour blindness</strong></li>\n</ul>\n</li>\n<li>Nausea, rashes, fever</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old patient is receiving a combination antiretroviral therapy including Zidovudine, Lamivudine, and Nevirapine for HIV management. Which of the following drugs should be avoided due to potential drug interactions with this regimen?", "options": [{"label": "A", "text": "Rifampicin", "correct": true}, {"label": "B", "text": "Streptomycin", "correct": false}, {"label": "C", "text": "INH", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "A. Rifampicin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - R\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the inclusion criterion for starting bedaquiline in a patient presenting with multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis?", "options": [{"label": "A", "text": "Resistance to both rifampicin and isoniazid with mutations in the inhA and katG genes", "correct": true}, {"label": "B", "text": "Resistance to rifampicin but sensitivity to fluoroquinolones", "correct": false}, {"label": "C", "text": "Resistance to rifampicin and sensitivity to isoniazid", "correct": false}, {"label": "D", "text": "Resistance to both rifampicin and fluoroquinolones", "correct": false}], "correct_answer": "A. Resistance to both rifampicin and isoniazid with mutations in the inhA and katG genes", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Resistance to Both &lt;span class=\"customMeta\" data-dictid=\"6cd890fc7416927771978562618db8\"&gt;Rifampicin&lt;/span&gt; and &lt;span class=\"customMeta\" data-dictid=\"5d8c24b3cb16927771909a5195d7f8\"&gt;Isoniazid&lt;/span&gt; with Mutations in the inhA and katG G\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drug dosages is incorrect for the treatment of leprosy in adults?", "options": [{"label": "A", "text": "Dapsone 100 mg", "correct": false}, {"label": "B", "text": "Clofazimine 50 mg", "correct": false}, {"label": "C", "text": "Clofazimine 300 mg", "correct": false}, {"label": "D", "text": "Rifampicin 450 mg", "correct": true}], "correct_answer": "D. Rifampicin 450 mg", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:631px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Paucibacillary</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multibacillary</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin lesions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-5 lesions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;5 lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nerve involvement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>≥1 nerve involved</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Slit skin smear</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Negative</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Positive</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:721px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dapsone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clofazimine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Paucibacillary (PB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adult</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>300 mg once a month &amp; 50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>600 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Child </strong></p>\n<p><strong>(9-14 yrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>150 mg once a month &amp; 50 mg <em>alternate day</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>450 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multibacillary (MB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adult</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>12 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>300 mg once a month &amp; 50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>600 mg once a month</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Child </strong></p>\n<p><strong>(9-14 yrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>12 months</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 mg daily</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>150 mg once a month &amp; 50 mg<em> <span class=\"customMeta\" data-dictid=\"d65e6c0e1616927771818ab537250d\">alternate</span> day</em></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>450 mg once a month</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug-resistant <span class=\"customMeta\" data-dictid=\"f200a5b7181692777191c4f24b2a3e\">leprosy</span> Regimen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intensive Phase</strong> (6 months)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Continuation Phase </strong>(18 months)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin-resistant cases:</strong></p>\n<p>2 second line + 1 first line (Clofazimine)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n<p><strong>(or)</strong></p>\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + Clofazimine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ofloxacin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n<p><strong>(or)</strong></p>\n<p>Ofloxacin + Clofazimine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin &amp; <span class=\"customMeta\" data-dictid=\"d78dc549171692777194a4af6724c2\">ofloxacin</span> resistant cases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clarithromycin + <span class=\"customMeta\" data-dictid=\"3d49c44f24169277719259eb6f9a14\">Minocycline</span> + Clofazimine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>(Clarithromycin or Minocycline) + Clofazimine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A TB patient with HIV begins ART and experiences deterioration in health after 2 months. What is the likely cause?", "options": [{"label": "A", "text": "Development of drug resistance to TB drugs", "correct": false}, {"label": "B", "text": "Drug-drug interactions between TB and ART medications", "correct": false}, {"label": "C", "text": "Immunological changes in the body", "correct": true}, {"label": "D", "text": "Development of drug resistance to ART", "correct": false}], "correct_answer": "C. Immunological changes in the body", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with penicillin allergy presents with fever, burning micturition, and hearing problems accompanied by dizziness. Which drug is the most appropriate for the management?", "options": [{"label": "A", "text": "Azithromycin", "correct": false}, {"label": "B", "text": "Amikacin", "correct": false}, {"label": "C", "text": "Ciprofloxacin", "correct": true}, {"label": "D", "text": "Ampicillin-Clavulanic acid", "correct": false}], "correct_answer": "C. Ciprofloxacin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ciprofloxacin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Good oral absorption</li>\n<li>Bioavailability ~70%,Moderate <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> (~4-5 hours)</li>\n<li>Widely distributed in tissues and body fluids</li>\n<li>Renal excretion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n<li>Prostatitis</li>\n<li>Pseudomonas aeruginosa (DOC)</li>\n<li><strong>Anthrax (Bacillus anthracis) (DOC)</strong></li>\n<li>Gastrointestinal infections (e.g., traveller's diarrhoea)</li>\n<li>Bone and joint infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastrointestinal disturbances (nausea, diarrhoea).</li>\n<li>CNS effects (headache, dizziness).</li>\n<li>Tendonitis and <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> rupture.</li>\n<li>Photosensitivity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pregnancy</li>\n<li>Children (due to potential for <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage)</li>\n<li>Myasthenia gravis (can exacerbate muscle weakness)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-tubercular drug is associated with mutations in the KATG gene?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Isoniazid", "correct": true}, {"label": "C", "text": "Moxifloxacin", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "B. Isoniazid", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/P1RB2BcpTtULStTLkxx01741070348.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>KatG gene mutation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>INH is a prodrug, converted to the active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> by catalase-peroxidase produced by the KATg gene. The mutated <span class=\"customMeta\" data-dictid=\"553253f1ce1692777183d395babc1b\">catalase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> does not <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the active drug</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>KasA gene mutation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Component of <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> mycolic acid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>InhA gene overexpression</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes <span class=\"customMeta\" data-dictid=\"9a6a6e737e1692777185f1b77971e2\">cross-resistance</span> to <span class=\"customMeta\" data-dictid=\"765ad61235169277718731b19650f4\">Ethionamide</span> (second-line drug)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs binds to CD4 and has both CXCR4 &amp;amp; CCR5 activity?", "options": [{"label": "A", "text": "Maraviroc", "correct": false}, {"label": "B", "text": "Ibalizumab", "correct": true}, {"label": "C", "text": "Dolutegravir", "correct": false}, {"label": "D", "text": "Tenofovir", "correct": false}], "correct_answer": "B. Ibalizumab", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following pathogens correctly matches its intrinsic drug resistance?", "options": [{"label": "A", "text": "Fluconazole - Candida krusei", "correct": true}, {"label": "B", "text": "Amphotericin B - Candida glabrata", "correct": false}, {"label": "C", "text": "Voriconazole - Aspergillus fumigatus", "correct": false}, {"label": "D", "text": "Itraconazole - Sporothrix", "correct": false}], "correct_answer": "A. Fluconazole - Candida krusei", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Antifungal class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Intrinsic resistance concerns</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Polyenes </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Binds to ergosterol, disrupting fungal cell membrane</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Limited <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> against some fungal species due to differences in <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> composition</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Amphotericin B</p>\n<p>Nystatin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Azoles </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"b797df98be1692777187039e0c9684\">ergosterol</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <span class=\"customMeta\" data-dictid=\"1ff7f443201692777191efc5e0efbd\">lanosterol</span> 14-alpha demethylase</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intrinsic resistance in some <span class=\"customMeta\" data-dictid=\"f54d5c5cf11692777183318f259e5f\">Candida</span> species</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Fluconazole</p>\n<p>Itraconazole</p>\n<p>Voriconazole</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Echinocandins </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits beta-glucan synthesis, disrupting fungal cell wall</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ineffective against <span class=\"customMeta\" data-dictid=\"df1857b4a6169277718597e7b3325d\">Cryptococcus</span> neoformans and Zygomycetes</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Caspofungin</p>\n<p>Micafungin</p>\n<p>Anidulafungin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Flucytosine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Converted to 5-fluorouracil inside fungal cells, disrupting <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> synthesis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intrinsic resistance in many fungi, including <span class=\"customMeta\" data-dictid=\"e3baadccd91692777182c9724090b3\">Aspergillus</span> and most molds</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Flucytosine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of doxycycline?", "options": [{"label": "A", "text": "Cell wall synthesis inhibitor", "correct": false}, {"label": "B", "text": "Protein synthesis inhibitor", "correct": true}, {"label": "C", "text": "DNA gyrase inhibitor", "correct": false}, {"label": "D", "text": "Leucyl-tRNA synthetase inhibitor", "correct": false}], "correct_answer": "B. Protein synthesis inhibitor", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8H9qf0BDgVdvgWvHPtJQ1745842933.png"], "explanation": "<p>Correct Answer B - Protein &lt;span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\"&gt;synthesis&lt;/span&gt; inhibitor</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Tetracycline </strong></p>\n<p style=\"text-align:center\"><strong>Oxytetracycline </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Demeclocycline </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Doxycycline </strong></p>\n<p style=\"text-align:center\"><strong>Minocycline </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Potency </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intermediate</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Plasma protein binding </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>high</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>6 - 12 hours</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>10 -16 hours</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>18- 24 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alteration of gut flora</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Altered</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Moderate alteration</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Least alteration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phototoxicity </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Highest </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Other <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tooth discoloration is less marked</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Diabetes insipidus</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Doxycycline has low <strong>nephrotoxicity. </strong></li>\n<li>Minocycline has <strong>Ototoxicity.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses of Tetracyclines</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Chlamydial Infections</strong>: Urethritis, Endocervicitis, Lymphogranuloma venereum, <span class=\"customMeta\" data-dictid=\"2334b7498b1692777188fa8b2eee36\">granuloma</span> inguinale.</li>\n<li><strong>Atypical Pneumonia: </strong>Mycoplasma pneumonia, Psittacosis.</li>\n<li>Rickettsial Infections.</li>\n<li>Pleurodesis: <span class=\"customMeta\" data-dictid=\"d0f202322516927771863db87b76e7\">Doxycycline</span> for pneumothorax.</li>\n<li>H. pylori Infection: Part of quadruple therapy.</li>\n<li>Anthrax, Plague, Borrelia.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The image below shows the life cycle of a virus. Which of the following drugs acts at step 5?", "options": [{"label": "A", "text": "Raltegravir", "correct": true}, {"label": "B", "text": "Enfuvirtide", "correct": false}, {"label": "C", "text": "Tenofovir", "correct": false}, {"label": "D", "text": "Zidovudine", "correct": false}], "correct_answer": "A. Raltegravir", "question_images": ["https://image.prepladder.com/notes/qga4NDeQMBCrhCkQDxbx1746709473.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Integrase inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevent the formation of <span class=\"customMeta\" data-dictid=\"d7f598a3db1692777185bf93a6e6fa\">covalent</span> bonds between host and <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA</li>\n<li>Inhibit the process known as <strong>strand transfer</strong>, which is a critical step in the integration of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA into the host genome.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ends with the word -gravir: <strong>BCDER</strong></p>\n<ul>\n<li>Bictegravir</li>\n<li>Cabotegravir</li>\n<li>Dolutegravir (most used in India and safe during pregnancy)</li>\n<li><strong>Elvitegravir</strong> (used in combination with cobicistat)</li>\n<li>Raltegravir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>All oral drugs except <strong>Cabotegravir</strong> (IM, once every 3 months)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CYP3A4 substrates</li>\n<li>Rifampicin reduces the effect, hence increasing the dose of the integrase inhibitor</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treatment and post-exposure <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of HIV</li>\n<li>Dolutegravir and Lamivudine: First line in treatment-naive HIV patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rashes</li>\n<li>Steven Johnson syndrome: Epidermis of the skin is damaged</li>\n<li>Raltegravir: Rhabdomyolysis, DRESS</li>\n<li>Bictegravir: Increase metformin concentration, hepatoxicity</li>\n<li>Avoid administration with <span class=\"customMeta\" data-dictid=\"9c9c29820b169277718670a8b16a3b\">divalent</span> cations (magnesium- or aluminium-containing antacids, iron supplements)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of antivirals </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reverse <span class=\"customMeta\" data-dictid=\"b3c46027e2169277720027542a8a15\">Transcriptase</span> Inhibitors (RTIs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit reverse transcriptase, the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> that converts <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> RNA into DNA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Zidovudine, Lamivudine, Tenofovir, Abacavir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Reverse <span class=\"customMeta\" data-dictid=\"b3c46027e2169277720027542a8a15\">Transcriptase</span> Inhibitors (RTIs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>They bind directly to reverse transcriptase, <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> its ability to transcribe <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> RNA into DNA.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Efavirenz, Nevirapine, Etravirine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protease Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> protease, preventing the <span class=\"customMeta\" data-dictid=\"76948f718016927771924774ade7e9\">maturation</span> of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> proteins and the assembly of new virions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ritonavir, Lopinavir, Atazanavir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Integrase Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit the integrase enzyme, preventing the integration of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> DNA into the host cell's genome.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Raltegravir, Dolutegravir, Elvitegravir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fusion Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prevent the <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> of the <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> envelope with the host cell membrane.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enfuvirtide (Fuzeon), Maraviroc</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neuraminidase Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit neuraminidase, an <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> needed for the release of new virions from infected cells.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oseltamivir (Tamiflu), Zanamivir</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is not considered safe for a pregnant woman diagnosed with extensively drug-resistant TB?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Clofazimine", "correct": false}, {"label": "C", "text": "Kanamycin", "correct": true}, {"label": "D", "text": "Linezolid", "correct": false}], "correct_answer": "C. Kanamycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - K\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old man who had travelled to Assam recently presents with fever, chills, seizures, and altered sensorium. On examination, his blood pressure is 70/50 mm Hg, and laboured breathing is observed. A blood smear reveals Plasmodium falciparum . What is the drug of choice in this condition?", "options": [{"label": "A", "text": "Chloroquine", "correct": false}, {"label": "B", "text": "Quinine", "correct": false}, {"label": "C", "text": "Intravenous artesunate", "correct": true}, {"label": "D", "text": "Artemether", "correct": false}], "correct_answer": "C. Intravenous artesunate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\"&gt;Intravenous&lt;/span&gt; artesunate</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Scenario</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uncomplicated P. Vivax malaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Chloroquine </strong>25 mg/kg over 3 days (10-10-5) + <strong>Primaquine </strong>oral 0.25 mg/kg for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Complicated malaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Parenteral ACT-Artesunate</strong> IV given for 2 days, <strong>followed by a full course of oral ACT.</strong></p>\n<p> </p>\n<p>(OR)</p>\n<p> </p>\n<p><strong>Parenteral quinine</strong> IV given for 2 days, and oral <span class=\"customMeta\" data-dictid=\"e19b9eeec016927771979899edd580\">quinine</span> given for 5 days. Add on oral doxycycline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mixed infection<br/>\n\t\t\t(P. vivax/ovale/falciparum)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>ACT+ Primaquine</strong> for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1st trimester: <strong>Parenteral quinine</strong></p>\n<p>2nd and 3rd trimester: <strong>Parenteral artemisinin</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was diagnosed with pulmonary tuberculosis and was started on first-time antitubercular drugs. Which of the following drugs acts by inhibiting the synthesis of the marked layer shown in the image?", "options": [{"label": "A", "text": "Isoniazid", "correct": true}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Pyrazinamide", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "A. Isoniazid", "question_images": ["https://image.prepladder.com/notes/4uAXpOK0WmooEUL0egoK1746705472.png"], "explanation_images": ["https://image.prepladder.com/notes/4SuecRq6zbD8iMfrDJn31745385343.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name of drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Isoniazid </strong><br/>\n<strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampin</strong><br/>\n<strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pyrazinamide</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ethambutol</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Streptomycin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"89e2535e2416927771930505f8f408\">mycolic acids</span> (cell wall).</p>\n<p>It also inhibits <span class=\"customMeta\" data-dictid=\"e99dbef99f169277719344843cf75a\">mycobacterium</span> DHFR, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with <span class=\"customMeta\" data-dictid=\"6483f3ef3116927771935d328a8ab2\">nucleic acid</span> synthesis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Interrupts RNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to mycobacterial DNA-dependent RNA polymerase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by getting converted into pyrazinoic acid</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in mycolic acid <span class=\"customMeta\" data-dictid=\"7bc107ea09169277719095466ee864\">incorporation</span> in the cell wall</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits 30S ribosomal protein synthesis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intramuscular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hepatotoxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cellularity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular and extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracellular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bactericidal/</strong><br/>\n<strong>Bacteriostatic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacteriostatic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bactericidal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacteria inhibited</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slow growers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly dividing M.TB</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The given diagram shows the steps in bacterial cell wall formation. Identify the site of action of beta-lactam antibiotics.", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "3", "correct": false}, {"label": "D", "text": "4", "correct": true}], "correct_answer": "D. 4", "question_images": ["https://image.prepladder.com/notes/oxRtzN9EfS5kIgGFD1Np1746709122.png"], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who is a known case of HIV is started on active antiretroviral therapy (cART). After 5 months of treatment, he developed hyperpigmentation in the palms and soles. What is likely the drug causing it?", "options": [{"label": "A", "text": "Nelfinavir", "correct": false}, {"label": "B", "text": "Emtricitabine", "correct": true}, {"label": "C", "text": "Abacavir", "correct": false}, {"label": "D", "text": "Zidovudine", "correct": false}], "correct_answer": "B. Emtricitabine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:620px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common side-effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name of Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side-effects </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abacavir</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Nucleoside-Reverse <span class=\"customMeta\" data-dictid=\"b3c46027e2169277720027542a8a15\">Transcriptase</span> Inhibitors (NRTIs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersensitivity reaction, headache, nausea, fatigue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zidovudine</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, headache, and fatigue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nelfinavir</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Protease Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diarrhea, nausea, and <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Antibiotics to use for procedures done on cardiac patients:", "options": [{"label": "A", "text": "Cefazolin", "correct": true}, {"label": "B", "text": "Azithromycin", "correct": false}, {"label": "C", "text": "Penicillin", "correct": false}, {"label": "D", "text": "Doxycycline", "correct": false}], "correct_answer": "A. Cefazolin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"74e05b271916927771848ff58d86f9\"&gt;Cefazolin&lt;/span&g\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>1st gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>2nd gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>3rd gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>4th gen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>5th gen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cephazolin</li>\n<li>Cephalexin</li>\n<li>Cefadroxil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cefuroxime</li>\n<li>Cefoxitin</li>\n<li>Cefaclor</li>\n<li>Cefprozil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cefotaxime</li>\n<li>Ceftizoxime</li>\n<li>Ceftriaxone</li>\n<li>Ceftazidime</li>\n<li>Cefpodoxime proxetil</li>\n<li>Cefdinir</li>\n<li>Ceftibuten</li>\n<li>Ceftamet pivoxil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cefepime</li>\n<li>Cefpirome</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ceftaroline</li>\n<li>Ceftobiprole</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A bronchial asthma patient on inhalational steroids with white patchy lesions on the tongue and buccal mucosa. Which of the following drugs can be used to treat this condition?", "options": [{"label": "A", "text": "Clotrimazole", "correct": true}, {"label": "B", "text": "Griseofulvin", "correct": false}, {"label": "C", "text": "Terbinafine", "correct": false}, {"label": "D", "text": "Flucytosine", "correct": false}], "correct_answer": "A. Clotrimazole", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ihJermivSMXZxy00otsz1745908353.png"], "explanation": "<p>Correct Answer A) C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antibiotics acts by inhibiting the 50s ribosome?", "options": [{"label": "A", "text": "Linezolid", "correct": true}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Aztreonam", "correct": false}, {"label": "D", "text": "Daptomycin", "correct": false}], "correct_answer": "A. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-color:black; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Linezolid</strong></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It inhibits bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the <strong>23S <span class=\"customMeta\" data-dictid=\"ff37e741eb1692777197a5d617b479\">ribosomal RNA</span> of the 50S ribosomal subunit</strong><strong>. </strong></li>\n<li>It interferes with the formation of the <span class=\"customMeta\" data-dictid=\"6e71126f6416927772001715e3e3a0\">ternary</span> N-formylmethionyl-tRNA (tRNAf-Met)-70S <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> complex, preventing the <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of protein synthesis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spectrum of Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Gram-positive <span class=\"customMeta\" data-dictid=\"57640139fe169277718418f95ae49f\">cocci</span> </strong>(aerobic and anaerobic): MRSA, VRSA, VRE, Strep. viridans, Strep. pneumoniae</li>\n<li>Other sensitive bacteria: Clostridia, B. fragilis, M. tuberculosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Common Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Uncomplicated and complicated skin and soft tissue infections <strong>Hospital-acquired pneumonia</strong> (HAPs)</li>\n<li>Bacteremia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and diarrhoea.</li>\n<li><strong>Chorioretinitis</strong></li>\n<li><strong>Optic neuritis</strong></li>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> (monitor <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> count)</li>\n<li>Caution is advised when used concurrently with <strong>MAO inhibitors </strong>due to the risk of <strong>serotonin syndrome.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old woman with MDR tuberculosis presents with fatigue, constipation, weight gain, and neck swelling. Which of the following drugs is implicated in this case?", "options": [{"label": "A", "text": "Cycloserine", "correct": false}, {"label": "B", "text": "Ethionamide", "correct": true}, {"label": "C", "text": "Streptomycin", "correct": false}, {"label": "D", "text": "Pyrazinamide", "correct": false}], "correct_answer": "B. Ethionamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with hemophilia on antiretroviral therapy is brought in with altered mental status following complaints of nausea, vomiting and headache. Which of the following medications was he taking?", "options": [{"label": "A", "text": "Tenofovir", "correct": false}, {"label": "B", "text": "Saquinavir", "correct": false}, {"label": "C", "text": "Tipranavir", "correct": true}, {"label": "D", "text": "Darunavir", "correct": false}], "correct_answer": "C. Tipranavir", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Protease inhibitors (PI): (-navir-)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Inhibits the assembly/packaging of <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> proteins</li>\n<li>Competitively inhibits the action of <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> <span class=\"customMeta\" data-dictid=\"d8b501495a16927771829f9857080b\">aspartyl</span> protease</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>All are CYP3A4 inhibitors:<strong> [Except Nelfinavir (CYP2C9)]</strong></p>\n<ul>\n<li>Increases <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> of other drugs</li>\n<li>Simvastatin: Risk of myopathy</li>\n<li>Midazolam: Causes <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>HIV treatment and 2nd line Post-exposure prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs: RAFTISLAND</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ritonavir\n\t\t\t\t<ul>\n<li>Maximum CYP <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> → inhibits <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> of other PI</li>\n<li>Low-dose <span class=\"customMeta\" data-dictid=\"dea585d18816927771975072308534\">ritonavir</span> boosts other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors (Lopinavir)</li>\n</ul>\n</li>\n<li>Amprenavir</li>\n<li>Fos-amprenavir</li>\n<li>Tipranavir</li>\n<li>Indinavir</li>\n<li>Saquinavir (least CYP inhibitor)</li>\n<li>Lopinavir</li>\n<li>Atazanavir (no dyslipidemia)</li>\n<li>Nelfinavir</li>\n<li>Darunavir (maximum bioavailability, taken with food)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Lipodystrophy</li>\n<li>Indinavir is a <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> associated with developing nephrolithiasis</li>\n<li>Tipranavir can cause altered mental status, headache, <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and hepatotoxicity.</li>\n<li>Ritonavir causes <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> disturbances, hyperlipidemia, hepatotoxicity.</li>\n<li>Atazanavir causes <span class=\"customMeta\" data-dictid=\"2f73e160ba1692777190d65065c95b\">Indirect</span> <span class=\"customMeta\" data-dictid=\"cab274fa4f1692777189f9b6dad514\">hyperbilirubinemia</span> (jaundice).</li>\n<li>Darunavir causes rash, liver function abnormalities, <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> disturbances</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>P-glycoprotein efflux transporter</li>\n<li>Cross-resistance with other <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A microorganism resistant to meropenem and aminoglycosides but sensitive to piperacillin clavulanate, cotrimoxazole? The causative organism is?", "options": [{"label": "A", "text": "Burkholderia cepacia", "correct": false}, {"label": "B", "text": "Acinetobacter", "correct": false}, {"label": "C", "text": "Pseudomonas", "correct": false}, {"label": "D", "text": "Stenotrophomonas", "correct": true}], "correct_answer": "D. Stenotrophomonas", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Stenotroph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with fever and eschar (as shown in the image below). What will be the treatment?", "options": [{"label": "A", "text": "Doxycycline", "correct": true}, {"label": "B", "text": "Doxycycline + Azithromycin", "correct": false}, {"label": "C", "text": "Ceftriaxone + Doxycycline", "correct": false}, {"label": "D", "text": "Ceftriaxone", "correct": false}], "correct_answer": "A. Doxycycline", "question_images": ["https://image.prepladder.com/content/ZXdubeUmNojz0JcLYj4w1744969230.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Scrub typhus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative agent </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><em>Orientia tsutsugamushi </em>(bacteria)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Transmission </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chiggers (larval mites)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vector </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trombiculid <span class=\"customMeta\" data-dictid=\"b7fceea4781692777192e02222d4e1\">mite</span> (<em>Leptotrombidium</em>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Geographical distribution </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Endemic in the “tsutsugamushi triangle” (parts of Asia, Australia, Pacific Islands).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical manifestations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fever, headache, muscle pain, <span class=\"customMeta\" data-dictid=\"6b73f3afaa1692777187f2899b6934\">eschar</span> (dark, scab-like <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> at the site of bite), and lymphadenopathy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Serological tests (ELISA, immunofluorescence) and molecular methods (PCR).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antibiotics (Doxycycline, Azithromycin)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevention </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Avoid mite-infested areas, wearing protective clothing, and using insect repellants.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Organ failure, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"afafb9026e1692777186e3dd168fa8\">distress</span> syndrome (ARDS), neurological complications.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the treatment of bacterial vaginosis (BV), which antibiotic is not recommended by the Centers for Disease Control and Prevention (CDC) guidelines?", "options": [{"label": "A", "text": "Metronidazole", "correct": false}, {"label": "B", "text": "Tinidazole", "correct": false}, {"label": "C", "text": "Clindamycin", "correct": false}, {"label": "D", "text": "Erythromycin", "correct": true}], "correct_answer": "D. Erythromycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Eryth\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which cellular process does Bedaquiline primarily target to exert its therapeutic effect, and how does this mechanism contribute to its antimycobacterial activity?", "options": [{"label": "A", "text": "ATP synthesis inhibition", "correct": true}, {"label": "B", "text": "Mycolic acid synthesis inhibition", "correct": false}, {"label": "C", "text": "Protein inhibition", "correct": false}, {"label": "D", "text": "Inhibiting reverse transcriptase enzyme", "correct": false}], "correct_answer": "A. ATP synthesis inhibition", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"5abb3a7e7f1692777182a8f4c42522\"&gt;ATP&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\"&gt;synthesis&lt;/span&gt; inh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug from the options provided is known as a protein synthesis inhibitor?", "options": [{"label": "A", "text": "Linezolide", "correct": true}, {"label": "B", "text": "Nevirapine", "correct": false}, {"label": "C", "text": "Indinavir", "correct": false}, {"label": "D", "text": "Ceftriazone", "correct": false}], "correct_answer": "A. Linezolide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - L\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Class of Antibiotic</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mechanism of Action (MOA)</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Penicillins</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to penicillin-binding proteins (PBPs)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Cephalosporins</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to PBPs</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Carbapenems</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to PBPs</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Monobactams</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to PBP3 in <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> bacteria</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Aminoglycosides</p>\n</td>\n<td>\n<p>Inhibit bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 30S ribosomal subunit</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tetracyclines</p>\n</td>\n<td>\n<p>Inhibit bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 30S ribosomal subunit</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Macrolides</p>\n</td>\n<td>\n<p>Inhibit bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Clindamycin</p>\n</td>\n<td>\n<p>Inhibit bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Quinolones</p>\n</td>\n<td>\n<p>Inhibit bacterial DNA <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by inhibiting <span class=\"customMeta\" data-dictid=\"27e761fe21169277718664069a016d\">DNA gyrase</span> and <span class=\"customMeta\" data-dictid=\"f3fc0b88991692777200b39f3208ec\">topoisomerase</span> IV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Sulfonamides</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by acting as competitive inhibitors of dihydropteroate synthase</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Trimethoprim</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by inhibiting <span class=\"customMeta\" data-dictid=\"0f9fe95f081692777186e5071229c6\">dihydrofolate</span> reductase</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Glycopeptides/Vancomycin</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> D-alanine-D-alanine moieties of <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> precursors</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Oxazolidinones</p>\n</td>\n<td>\n<p>Inhibit bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 23S <span class=\"customMeta\" data-dictid=\"ff37e741eb1692777197a5d617b479\">ribosomal RNA</span> of the 50S subunit</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lipopeptides/Daptomycin</p>\n</td>\n<td>\n<p>Disrupt bacterial cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity and cause depolarization</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Polymyxins</p>\n</td>\n<td>\n<p>Disrupt bacterial cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> integrity and cause leakage of <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> contents</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Rifampin</p>\n</td>\n<td>\n<p>Inhibit bacterial <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to bacterial <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> polymerase</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-tubercular drugs is associated with ophthalmic toxicity ?", "options": [{"label": "A", "text": "Ethambutol", "correct": true}, {"label": "B", "text": "Isoniazid", "correct": false}, {"label": "C", "text": "Kanamycin", "correct": false}, {"label": "D", "text": "Rifampin", "correct": false}], "correct_answer": "A. Ethambutol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ethambu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true about tedizolid ?", "options": [{"label": "A", "text": "Active against gram positive organisms", "correct": true}, {"label": "B", "text": "Poor oral bioavailability", "correct": false}, {"label": "C", "text": "Active against anaerobes", "correct": false}, {"label": "D", "text": "Causes peripheral neuropathy", "correct": false}], "correct_answer": "A. Active against gram positive organisms", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Tedizolid is active against &lt;span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\"&gt;gram-positive&lt;/span&gt; org\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Tedizolid</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Information</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\">Classification</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Antibiotic</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Mechanism of Action</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Inhibits bacterial protein synthesis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Spectrum of Activity</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Active against <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> organisms</p>\n</td>\n</tr>\n<tr>\n<td style=\"text-align:center\"> </td>\n<td>\n<p style=\"text-align: center;\">Including <span class=\"customMeta\" data-dictid=\"fdcadd75c416927771935379e47ef6\">MRSA</span> and VRE</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Oral Bioavailability</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Good</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Activity Against Anaerobes</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Limited</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the drug of choice for scrub typhus during pregnancy and otherwise respectively ?", "options": [{"label": "A", "text": "Chloramphenicol, Doxycycline", "correct": false}, {"label": "B", "text": "Doxycycline, Doxycycline", "correct": false}, {"label": "C", "text": "Doxycycline, Azithromycin", "correct": false}, {"label": "D", "text": "Azithromycin, Doxycycline", "correct": true}], "correct_answer": "D. Azithromycin, Doxycycline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Azithromycin, D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is gametocidal to all the species causing malaria ?", "options": [{"label": "A", "text": "Primaquine", "correct": true}, {"label": "B", "text": "Chloroquine", "correct": false}, {"label": "C", "text": "Quinine", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "A. Primaquine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Primaqu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the incorrect pairing of antifungals with their respective mechanisms of action .:", "options": [{"label": "A", "text": "Ketoconazole: Lanosterol-14-demethylase inhibition", "correct": false}, {"label": "B", "text": "Flucytosine: Inhibits microtubule synthesis and thus hinders mitosis", "correct": true}, {"label": "C", "text": "Terbinafine: Squalene epoxidase inhibition", "correct": false}, {"label": "D", "text": "Amphotericin B: Sequesters ergosterol", "correct": false}], "correct_answer": "B. Flucytosine: Inhibits microtubule synthesis and thus hinders mitosis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Flucytosine: Inhibits &lt;span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\"&gt;microtubule&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\"&gt;synthesis&lt;/span&gt; and thus h\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Ketoconazole</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p>Inhibit 14 <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> demethylase enzyme</p>\n</td>\n</tr>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Flucytosine</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"e34386023d169277720036d8bccc88\">thymidylate</span> <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> enzyme</p>\n</td>\n</tr>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Terbinafine</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"bb2a5fcdd11692777199c2f5034e4a\">squalene</span> epoxidase</p>\n</td>\n</tr>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Amphotericin B</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p>Creates pores in the cell <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> by disrupting ergosterol.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs could potentially be responsible for the patient's development of nephrolithiasis ?", "options": [{"label": "A", "text": "Ketoconazole", "correct": false}, {"label": "B", "text": "Indinavir", "correct": true}, {"label": "C", "text": "Lamivudine", "correct": false}, {"label": "D", "text": "Zidovudine", "correct": false}], "correct_answer": "B. Indinavir", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Indinav\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>NRTI: </strong>Zidovudine, Lamivudine </p>\n</td>\n<td>\n<ul>\n<li>\n<p>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</p>\n<ul>\n<li>\n<p>Alopecia</p>\n</li>\n<li>\n<p>Myopathy</p>\n</li>\n<li>\n<p>Pancreatitis</p>\n</li>\n<li>\n<p>Peripheral neuropathy</p>\n</li>\n<li>\n<p>Hepatic steatosis</p>\n</li>\n<li>\n<p><strong>Lipodystrophy: </strong>Obese, type 2DM</p>\n</li>\n<li>\n<p><strong>Lactic acidosis</strong>: <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of mitochondrial respiration</p>\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>NNRTI:</strong> <span class=\"customMeta\" data-dictid=\"5b737ea2b4169277719338ba5f0a07\">Nevirapine</span> , Efavirenz</p>\n</td>\n<td>\n<ul>\n<li>\n<p>Hypersensitivity rashes</p>\n</li>\n<li>\n<p>Steven Johnson syndrome</p>\n</li>\n<li>\n<p><strong>Nevirapine:</strong> Hepatotoxicity</p>\n</li>\n<li>\n<p><strong>Efavirenz:</strong> Neurotoxicity</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Integrase inhibitors:</strong> Bictegravir, Raltegravir</p>\n</td>\n<td>\n<ul>\n<li>\n<p>Hypersensitivity rashes</p>\n</li>\n<li>\n<p>Steven Johnson syndrome</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Protease inhibitors</p>\n</td>\n<td>\n<ul>\n<li>\n<p>Lipodystrophy syndrome</p>\n</li>\n<li>\n<p>Obesity, Breast hypertrophy</p>\n<ul>\n<li>\n<p><strong>Type 2 DM</strong>: <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> resistance</p>\n</li>\n<li>\n<p>Dyslipidemia</p>\n</li>\n</ul>\n</li>\n<li>\n<p><strong>Renal stone (Nephrolithiasis): </strong>Indinavir - specific side effect</p>\n</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antimicrobials is effective against an organism producing extended-spectrum beta-lactamases ?", "options": [{"label": "A", "text": "Amoxicillin – Clavulanic acid", "correct": false}, {"label": "B", "text": "Penicillin", "correct": false}, {"label": "C", "text": "Piperacillin – Tazobactam", "correct": true}, {"label": "D", "text": "Ceftriaxone", "correct": false}], "correct_answer": "C. Piperacillin – Tazobactam", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Piperacillin – T\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the drug of choice for scrub typhus ?", "options": [{"label": "A", "text": "Doxycycline", "correct": true}, {"label": "B", "text": "Azithromycin", "correct": false}, {"label": "C", "text": "Chloramphenicol", "correct": false}, {"label": "D", "text": "Ciprofloxacin", "correct": false}], "correct_answer": "A. Doxycycline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - D\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p><strong>Older </strong></p>\n</td>\n<td>\n<p><strong>Newer</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tetracycline, Oxytetracycline, Chlortetracycline, Demeclocycline</p>\n</td>\n<td>\n<p>Doxycycline, Minocycline, Tigecycline </p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Incomplete absorption </p>\n</td>\n<td>\n<p>Good oral absorption </p>\n</td>\n</tr>\n<tr>\n<td>\n<p>More chance of diarrhoea </p>\n</td>\n<td>\n<p>Less chance of diarrhoea</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Food interactions (milk, antacids)</p>\n</td>\n<td>\n<p>Less Food interactions</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An example of a bacteriostatic drug is ________________:", "options": [{"label": "A", "text": "Aminoglycoside", "correct": false}, {"label": "B", "text": "Vancomycin", "correct": false}, {"label": "C", "text": "Metronidazole", "correct": false}, {"label": "D", "text": "Linezolid", "correct": true}], "correct_answer": "D. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - L\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Bacteriostatic Drugs</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Bactericidal Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tetracycline</p>\n</td>\n<td>\n<p>Penicillin</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Macrolides (e.g., erythromycin)</p>\n</td>\n<td>\n<p>Cephalosporins</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Clindamycin</p>\n</td>\n<td>\n<p>Fluoroquinolones (e.g., ciprofloxacin)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Chloramphenicol</p>\n</td>\n<td>\n<p>Aminoglycosides (e.g., gentamicin)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Sulfonamides (e.g., trimethoprim-sulfamethoxazole)</p>\n</td>\n<td>\n<p>Vancomycin</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Linezolid</p>\n</td>\n<td>\n<p>Metronidazole</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following carbapenems has increased risk of causing seizures ?", "options": [{"label": "A", "text": "Meropenem", "correct": false}, {"label": "B", "text": "Imipenem", "correct": true}, {"label": "C", "text": "Etrapenem", "correct": false}, {"label": "D", "text": "Doripenem", "correct": false}], "correct_answer": "B. Imipenem", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - I\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of triazoles ?", "options": [{"label": "A", "text": "Interferes with DNA and RNA synthesis", "correct": false}, {"label": "B", "text": "Inhibition of ergosterol synthesis", "correct": true}, {"label": "C", "text": "Forms pores in fungal membranes", "correct": false}, {"label": "D", "text": "Inhibits epoxidation of squalene in fungi", "correct": false}], "correct_answer": "B. Inhibition of ergosterol synthesis", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following fluoroquinolones has maximum bioavailability ?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Levofloxacin", "correct": true}, {"label": "C", "text": "Gatifloxacin", "correct": false}, {"label": "D", "text": "Norfloxacin", "correct": false}], "correct_answer": "B. Levofloxacin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Levofloxacin.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of oseltamivir and zanamivir ?", "options": [{"label": "A", "text": "DNA polymerase inhibition", "correct": false}, {"label": "B", "text": "Protein synthesis inhibition", "correct": false}, {"label": "C", "text": "Nucleotide analogue", "correct": false}, {"label": "D", "text": "Neuraminidase inhibition", "correct": true}], "correct_answer": "D. Neuraminidase inhibition", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"257d9cb9fb1692777193840b7918f6\"&gt;Neuraminidase&lt;/span&gt; inhibition.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the drug of choice for diphtheria carrier state ?", "options": [{"label": "A", "text": "Amoxicillin", "correct": false}, {"label": "B", "text": "Erythromycin", "correct": true}, {"label": "C", "text": "Rifampicin", "correct": false}, {"label": "D", "text": "Tetracycline", "correct": false}], "correct_answer": "B. Erythromycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Eryth\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Type of Diphtheria</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Treatment of Choice</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Respiratory diphtheria</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Diphtheria <span class=\"customMeta\" data-dictid=\"2ff0b3039f16927771818bb2a247b0\">antitoxin</span> (DAT)</p>\n</li>\n<li>\n<p>Antibiotic therapy (e.g., erythromycin)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Cutaneous diphtheria</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Local wound care</p>\n</li>\n<li>\n<p>Antibiotic therapy (e.g., erythromycin)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Nasopharyngeal diphtheria</strong></p>\n<p><strong>Laryngeal or pharyngeal diphtheria</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Diphtheria <span class=\"customMeta\" data-dictid=\"2ff0b3039f16927771818bb2a247b0\">antitoxin</span> (DAT)</p>\n</li>\n<li>\n<p>Antibiotic therapy (e.g., erythromycin)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Diphtheria carrier state</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Antibiotic therapy (e.g., erythromycin)</p>\n</li>\n<li>\n<p>Close contact prophylaxis</p>\n</li>\n<li>\n<p>Immunization of contacts and carriers</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A diabetic patient presents with a fungal sinus and peri-orbital region infection with significant visual impairment , as shown below. The most appropriate drug for the treatment of this patient is:", "options": [{"label": "A", "text": "Itraconazole", "correct": false}, {"label": "B", "text": "Liposomal amphotericin B", "correct": true}, {"label": "C", "text": "Ketoconazole", "correct": false}, {"label": "D", "text": "Broad spectrum antibiotics", "correct": false}], "correct_answer": "B. Liposomal amphotericin B", "question_images": ["https://image.prepladder.com/content/Lyx9NHPNuEF1kibITimd1715143907.png"], "explanation_images": [], "explanation": "<p>Correct Option B - Liposomal amphotericin B\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Drug of choice for nasal carriers of MRSA is:", "options": [{"label": "A", "text": "Vancomycin", "correct": false}, {"label": "B", "text": "Teicoplanin", "correct": false}, {"label": "C", "text": "Mupirocin", "correct": true}, {"label": "D", "text": "Linezolid", "correct": false}], "correct_answer": "C. Mupirocin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Mu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Assertion : In a patient admitted in hospital for community – acquired pneumonia, combination therapy of beta – lactams and azithromycin is given. Reason : This combination covers Gram – positive organisms and anaerobes", "options": [{"label": "A", "text": "Both assertion and reason are true and the reason is the correct explanation for the assertion", "correct": false}, {"label": "B", "text": "Both assertion and reason are true, but the reason is not the correct explanation for the assertion", "correct": false}, {"label": "C", "text": "Assertion is true, but the reason is false", "correct": true}, {"label": "D", "text": "Both assertion and reason are false", "correct": false}, {"label": "E", "text": "The assertion is false but reason is true", "correct": false}], "correct_answer": "C. Assertion is true, but the reason is false", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Assertion is true, but th\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Clostridium difficile associated diarrhea occurs maximally due to:", "options": [{"label": "A", "text": "Lincosamides", "correct": true}, {"label": "B", "text": "Tetracyclines", "correct": false}, {"label": "C", "text": "Carbapenems", "correct": false}, {"label": "D", "text": "Macrolide", "correct": false}], "correct_answer": "A. Lincosamides", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Lincosamides: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 103 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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He has a medical history significant for glucose-6-phosphate dehydrogenase (G6PD) deficiency. Laboratory investigations reveal hemoglobinuria and a decreased hemoglobin level. The patient is diagnosed with a hemolytic crisis secondary to G6PD deficiency. Which of the following antibiotics is safest to administer to this patient?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Azithromycin", "correct": true}, {"label": "C", "text": "Metronidazole", "correct": false}, {"label": "D", "text": "Nitrofurantoin", "correct": false}], "correct_answer": "B. Azithromycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:526px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safe in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unsafe in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: PCM</p>\n<ul>\n<li><strong>P</strong>enicillins</li>\n<li><strong>C</strong>ephalosporins</li>\n<li><strong>M</strong>acrolides <strong>(Option B)</strong></li>\n<li><strong>M</strong>efloquine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: MAD FAN Can</p>\n<ul>\n<li><strong>M</strong>etronidazole <strong>(Option C ruled out)</strong></li>\n<li><strong>A</strong>ntimalarials- except mefloquine</li>\n<li><strong>D</strong>apsone</li>\n<li><strong>F</strong>luoroquinolones<strong> (Option A ruled out)</strong></li>\n<li><strong>A</strong>spirin</li>\n<li><strong>N</strong>itro drugs- <span class=\"customMeta\" data-dictid=\"5416c4dafd1692777193ae03602f5a\">Nitrofurantoin</span> <strong>(Option D ruled out)</strong></li>\n<li><strong>C</strong>hloramphenicol</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old pregnant woman at 32 weeks gestation presents with symptoms suggestive of a urinary tract infection (UTI). She has a past medical history of penicillin allergy but is otherwise healthy. Considering her pregnancy status, which of the following antibiotics would be contraindicated due to potential adverse effects on the fetus?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Cephalexin", "correct": false}, {"label": "C", "text": "Amoxicillin", "correct": false}, {"label": "D", "text": "Ciprofloxacin", "correct": true}], "correct_answer": "D. Ciprofloxacin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:643px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safe in pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unsafe in pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: PCM</p>\n<ul>\n<li><strong>P</strong>enicillins <strong>(Option C ruled out)</strong></li>\n<li><strong>C</strong>ephalosporins (<strong>Option B ruled out)</strong></li>\n<li><strong>M</strong>acrolides <strong>(Option A ruled out)</strong></li>\n<li><strong>M</strong>efloquine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: FATS</p>\n<ul>\n<li><strong>F</strong>luoroquinolones: <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">Fetal</span> bone and <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage due to chelating effect <strong>(Option D)</strong></li>\n<li><strong>A</strong>minoglycosides: <span class=\"customMeta\" data-dictid=\"2120ab70f61692777194f45de53df3\">Ototoxic</span> to the fetus</li>\n<li><strong>T</strong>etracycline</li>\n<li><strong>S</strong>ulphonamides: <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">Fetal</span> bone and <span class=\"customMeta\" data-dictid=\"c6f61cdbe41692777183fdc8f95f96\">cartilage</span> damage due to chelating effect, <span class=\"customMeta\" data-dictid=\"34fea2624516927771905a0047f439\">kernicterus</span> in 3rd trimester</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following are not safe to use in severe renal disease?", "options": [{"label": "A", "text": "Linezolid", "correct": false}, {"label": "B", "text": "Rifampicin", "correct": false}, {"label": "C", "text": "Tobramycin", "correct": true}, {"label": "D", "text": "Cefoperazone", "correct": false}], "correct_answer": "C. Tobramycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:667px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Renal safe antibiotics</strong></p>\n<p>Drugs that are excreted in <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> are safe to use in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> disease (No dose reduction required)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: Totally Contraindicated In <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">RENAL</span> Failure Disease</p>\n<ul>\n<li><strong>T</strong>igecycline</li>\n<li><strong>C</strong>efoperazone<strong> (Option D ruled out)</strong></li>\n<li><strong>I</strong>soniazid</li>\n<li><strong>R</strong>ifampicin<strong> (Option B ruled out)</strong></li>\n<li><strong>E</strong>rythromycin</li>\n<li><strong>N</strong>afcillin</li>\n<li><strong>A</strong>zithromycin</li>\n<li><strong>L</strong>inezolid<strong> (Option A ruled out)</strong></li>\n<li><strong>F</strong>luoroquinolones- Pefloxacin, Moxifloxacin, Trovafloxacin</li>\n<li><strong>D</strong>oxycycline</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) accurately distinguishes bactericidal from bacteriostatic drugs?", "options": [{"label": "A", "text": "Bactericidal drugs have a narrower range between MIC and MBC than bacteriostatic drugs", "correct": true}, {"label": "B", "text": "Bacteriostatic drugs show a higher MIC to MBC ratio than bactericidal drugs", "correct": false}, {"label": "C", "text": "Both drug types have similar MIC but different MBC values", "correct": false}, {"label": "D", "text": "Bactericidal drugs have higher MIC but lower MBC values than bacteriostatic drugs", "correct": false}], "correct_answer": "A. Bactericidal drugs have a narrower range between MIC and MBC than bacteriostatic drugs", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:592px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacteriostatic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bactericidal</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MIC&lt;&lt;&lt;MBC</li>\n<li>Bacterial growth is restricted but not killed</li>\n<li>The remaining bacteria are killed by the <span class=\"customMeta\" data-dictid=\"4f9ee631c21692777189b1e0cdc91c\">immunity</span> of the body</li>\n<li>Examples- Tetracyclines, macrolides</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MIC = MBC</li>\n<li>Bacteria are completely killed</li>\n<li>Examples- Beta-lactams, Fluoroquinolones, aminoglycosides</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the Post-Antibiotic Effect (PAE)?", "options": [{"label": "A", "text": "The ability of antibiotics to continue killing bacteria post-administration", "correct": false}, {"label": "B", "text": "The period during which bacteria develop resistance post-antibiotic exposure", "correct": false}, {"label": "C", "text": "The ability of antibiotics to suppress bacterial growth beyond MIC", "correct": false}, {"label": "D", "text": "Extended inhibition of bacterial regrowth post-antibiotic clearance", "correct": true}], "correct_answer": "D. Extended inhibition of bacterial regrowth post-antibiotic clearance", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ZpsNXSGIIDLnCKGm2owy1736526291.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:824px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Concentration-dependent killing (CDK)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Represents the dose of antimicrobials above <span class=\"customMeta\" data-dictid=\"5da50ff5e61692777192f0fd27880a\">MIC</span> that can kill the microbe</li>\n<li>It is a single high-dose</li>\n<li>Examples- Aminoglycosides and metronidazole</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time-dependent killing (TDK)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Represents the duration over a longer period of time for antimicrobials to kill the bacteria</li>\n<li>It is multiple daily doses.</li>\n<li>Examples- Penicillin, Azithromycin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CTDK (combination of <span class=\"customMeta\" data-dictid=\"21f7c13ced1692777183f46684de3a\">CDK</span> &amp;TDK)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CTDK is also known as area-dependent killing.</li>\n<li>Examples- Vancomycin, Fluoroquinolones</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">Antibiotic</span> Effect (PAE)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prolonged <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of bacterial growth after <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">antibiotic</span> exposure, even when drug levels fall below MIC, due to the body's immune response.</li>\n<li>Advantage: Duration of therapy can be reduced.</li>\n<li>E.g. In TB, <span class=\"customMeta\" data-dictid=\"6cd890fc7416927771978562618db8\">Rifampicin</span> is given once a day due to its <span class=\"customMeta\" data-dictid=\"21f7c13ced1692777183f46684de3a\">CDK</span> property, but in leprosy, it is given once a month to utilise its <span class=\"customMeta\" data-dictid=\"86aac0bc231692777194db147cadfb\">PAE</span> effectively.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which statement is true about acquired resistance?", "options": [{"label": "A", "text": "It depends on both the microorganism and the drug", "correct": true}, {"label": "B", "text": "It depends only on the microorganism", "correct": false}, {"label": "C", "text": "It depends only on the drug", "correct": false}, {"label": "D", "text": "It is independent of the microorganism and the drug", "correct": false}], "correct_answer": "A. It depends on both the microorganism and the drug", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:839px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Natural resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acquired resistance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Some microbes lack the <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> process or target site the particular drug affects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Development of resistance by an organism (sensitive before) due to the use of an <span class=\"customMeta\" data-dictid=\"b1dc38e1211692777181ab12accbbb\">AMA</span> over a period of time</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>e.g.</p>\n<ul>\n<li>gram-negative <span class=\"customMeta\" data-dictid=\"fe0005a48b1692777182143f69e1d5\">bacilli</span> are unaffected by <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> G</li>\n<li>aerobic organisms are not affected by metronidazole</li>\n<li>anaerobic bacteria are not inhibited by <span class=\"customMeta\" data-dictid=\"0291b75d1416927771817e25f028c9\">aminoglycoside</span> antibiotics</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The development of resistance is dependent on the <span class=\"customMeta\" data-dictid=\"03aede3b101692777192c7f7a5e99c\">microorganism</span> as well as on the drug.</p>\n<p>Some bacteria rapidly acquire resistance,</p>\n<p>e.g. staphylococci, coliforms, <span class=\"customMeta\" data-dictid=\"4e55f7e0e6169277720158750ed95c\">tubercle</span> bacilli, gonococci</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This does not pose a significant clinical problem</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This can happen with any <span class=\"customMeta\" data-dictid=\"c5b68c41f916927771929b9102bfcf\">microbe</span> and is a major clinical problem</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>They are of 2 types</p>\n<ul>\n<li>Mutation</li>\n<li>Gene transfer</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The transfer of antimicrobial resistance through a virus called bacteriophage is called?", "options": [{"label": "A", "text": "Conjugation", "correct": false}, {"label": "B", "text": "Transduction", "correct": true}, {"label": "C", "text": "Transformation", "correct": false}, {"label": "D", "text": "Multistep mutation", "correct": false}], "correct_answer": "B. Transduction", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/DXjVoLsZCcD9h4VVORA01734437817.png", "https://image.prepladder.com/content/PjoS7xdKqvOoSOIPCabA1734437851.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:766px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mutation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Gene transfer</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">It is a stable and <span class=\"customMeta\" data-dictid=\"4a578d172616927771884c86860c21\">heritable</span> genetic change that occurs spontaneously and randomly among microorganisms</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">The gene that causes resistance is passed from one organism to another</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Vertical transfer of resistance; relatively slow and usually of lower grade</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Horizontal transfer of resistance; rapid spread; high-level resistance to several antibiotics</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There are 2 types</p>\n<ul>\n<li><strong>Single step</strong>: A single gene <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> confers high resistance, emerging rapidly (e.g., enterococci to streptomycin)</li>\n<li><strong>Multistep</strong>: Several gene modifications are involved; sensitivity decreases gradually stepwise. (e.g., resistance to erythromycin, tetracyclines and chloramphenicol)<strong> (Option D)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There are 3 types</p>\n<ul>\n<li><strong>Conjugation: </strong>One bacteria acquires a resistance gene from another bacteria via <span class=\"customMeta\" data-dictid=\"795d6c91ea16927771954ebce2fadf\">plasmid</span> (e.g., <span class=\"customMeta\" data-dictid=\"3c0021ebec1692777192f766374e40\">MDR</span> TB, typhoid)<strong>(Option A)</strong></li>\n<li><strong>Transduction:</strong> Bacteria acquire resistance genes from a <span class=\"customMeta\" data-dictid=\"81495024f1169277718242d46f70f7\">bacteriophage</span> (e.g., MRSA)</li>\n<li><strong>Transformation</strong>-Bacteria acquire genes directly from the environment (e.g., pneumococci, gonococci)<strong>(Option C)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Bacteria lacking a cell wall, such as Mycoplasma species, primarily exhibit resistance through which mechanism?", "options": [{"label": "A", "text": "Drug Efflux", "correct": false}, {"label": "B", "text": "Drug Influx", "correct": true}, {"label": "C", "text": "Enzyme Inactivation", "correct": false}, {"label": "D", "text": "Mutation in Target", "correct": false}], "correct_answer": "B. Drug Influx", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:882px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Efflux</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacteria possess efflux pumps to expel toxic substances and <span class=\"customMeta\" data-dictid=\"78d28b340916927771810a3fffeb0a\">antimicrobial</span> agents (AMAs)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antimalarials (chloroquine), Tetracyclines, Tigecycline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Influx</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Natural mechanisms in bacteria prevent the <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> of AMAs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mycoplasma (resistant to β-lactams and glycopeptides due to lack of cell wall)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Enzyme inactivation</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacterial enzymes like β-lactamases <span class=\"customMeta\" data-dictid=\"8bc8a6d0441692777190e9bed75e91\">inactivate</span> β-lactam drugs by hydrolysing a specific site in their ring structure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>β-lactams (penicillins, cephalosporins), Aminoglycosides, Chloramphenicol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mutation in target</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacteria modify components of their cell to resist AMAs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>β-lactam resistance in <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> bacteria via altered penicillin-binding proteins (PBPs), Fluoroquinolones (DNA gyrase mutation), Vancomycin (van genes altering <span class=\"customMeta\" data-dictid=\"8d8d5e23f3169277719592e0c8d2b4\">peptidoglycan</span> precursors)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "When combining a bactericidal and bacteriostatic drug, what is the most likely outcome?", "options": [{"label": "A", "text": "Drug antagonism", "correct": true}, {"label": "B", "text": "Drug synergism", "correct": false}, {"label": "C", "text": "Both Drug antagonism and drug synergism", "correct": false}, {"label": "D", "text": "Neither Drug antagonism nor drug synergism", "correct": false}], "correct_answer": "A. Drug antagonism", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:777px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug <span class=\"customMeta\" data-dictid=\"7b3b2b25931692777199e1d3e5fadf\">synergism</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug <span class=\"customMeta\" data-dictid=\"99de407a1516927771818ac910ab5f\">antagonism</span> (Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supra-additive effect when different <span class=\"customMeta\" data-dictid=\"78d28b340916927771810a3fffeb0a\">antimicrobial</span> agents (AMAs) are combined, enhancing <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> beyond individual effects.<br/>\n\t\t\t </p>\n<ul>\n<li><strong>Sequential <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> block:</strong><br/>\n\t\t\t\tE.g.,Sulfonamide + trimethoprim: Sequentially blocks bacterial <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">folate</span> metabolism, leading to cidal action together compared to <span class=\"customMeta\" data-dictid=\"0e0dce452a1692777198212234f2f0\">static</span> effects individually.<br/>\n\t\t\t\t </li>\n<li><strong>Block drug inactivating enzyme:</strong><br/>\n\t\t\t\tE.g., <span class=\"customMeta\" data-dictid=\"e1a1f4fa35169277718150f74fa895\">Ampicillin</span> + Sulbactam: β-lactamases block <span class=\"customMeta\" data-dictid=\"e1a1f4fa35169277718150f74fa895\">ampicillin</span> but <span class=\"customMeta\" data-dictid=\"1bb3e801ee169277719996c1d2fd4f\">sulbactam</span> blocks β-lactamases.<br/>\n\t\t\t\t </li>\n<li><strong>Increase entry of the drug into microbes:</strong><br/>\n\t\t\t\tE.g., <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">Cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitors increase the entry of aminoglycosides (Ceftazidime enhances <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">gentamicin</span> <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> against Pseudomonas).</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>When two AMAs belonging to different classes are used together, they sometimes have a negative effect on each other.</p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Bactericidal + Bacteriostatic</strong>: Combining them may diminish the effect of <span class=\"customMeta\" data-dictid=\"1019212c0716927771822d4942335e\">bacteriostatic</span> drugs. E.g., <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> + tetracycline/chloramphenicol against <span class=\"customMeta\" data-dictid=\"01085a42b81692777195e18240b671\">pneumococci</span> can increase mortality rates compared to <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> alone.<br/>\n\t\t\t\t </li>\n<li>Penicillin can deactivate aminoglycosides when both are present together.<br/>\n\t\t\t\t </li>\n<li>Bacteria can produce beta-lactamases that degrade other beta-lactam antibiotics when used in combination.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 19 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Drugs Mechanism of action 1 Linezolid A. Blocks 50s ribosomal subunit; interferes with translocation 2 Tetracycline B. Block 23s subunit on 50s ribosome, interferes with formylmethionine-tRNA 70S complex formation 3 Erythromycin C. Blocks 30s ribosomal subunit; causes misreading of mRNA 4 Streptomycin D. Blocks 30S mRNA-ribosome; inhibits attachment of aminoacyl-t-RNA to the acceptor (A) site.", "options": [{"label": "A", "text": "1-B, 2-D, 3-C, 4-A", "correct": false}, {"label": "B", "text": "1-B, 2-D, 3-A, 4-C", "correct": true}, {"label": "C", "text": "1-D, 2-A, 3-B, 4-C", "correct": false}, {"label": "D", "text": "1-C, 2-B, 3-A, 4-D", "correct": false}], "correct_answer": "B. 1-B, 2-D, 3-A, 4-C", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ribosomal subunit blocked </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Linezolid </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Block 23s subunit on 50s ribosome.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Interferes with formylmethionine-tRNA 70S <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> complex formation, thus preventing protein synthesis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tetracycline /tigecycline</strong></p>\n<p><strong>Doxycycline</strong></p>\n<p><strong>Demeclocycline</strong></p>\n<p><strong>Minocycline </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks 30S <span class=\"customMeta\" data-dictid=\"d6f42e0fac169277719339c004a084\">mRNA</span> - ribosome.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"ccd357daaf16927771825777ea6a0d\">attachment</span> of aminoacyl-t-RNA to the <span class=\"customMeta\" data-dictid=\"138fddb804169277718051e3eab3a4\">acceptor</span> (A) site.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aminoglycosides </strong></p>\n<ul>\n<li><strong>Streptomycin </strong></li>\n<li><strong>Amikacin </strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Misreading of mRNA</li>\n<li>Inhibit <span class=\"customMeta\" data-dictid=\"a50bb0cd941692777196f2182cb4fb\">polysome</span> formation (Attachment of ribosomes on mRNA)</li>\n<li>Inhibits <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of protein synthesis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chloramphenicol </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks 50s ribosomal subunit.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits transfer of the elongating <span class=\"customMeta\" data-dictid=\"53172b32401692777195efbbb6b2e8\">peptide</span> chain</p>\n<p>to the newly attached aminoacyl-tRNA.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macrolides</strong></p>\n<ul>\n<li><strong>Erythromycin</strong></li>\n<li><strong>Azithromycin </strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Interferes with translocation.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A drug sensitivity test of a patient's sputum sample shows the presence of vancomycin-resistant MRSA. A narrow-spectrum protein synthesis inhibitor antibiotic that inhibits the formation of formylmethionine-tRNA 70S initiation complex was started for the patient. Which drug was most likely used?", "options": [{"label": "A", "text": "Azithromycin", "correct": false}, {"label": "B", "text": "Linezolid", "correct": true}, {"label": "C", "text": "Chloramphenicol", "correct": false}, {"label": "D", "text": "Clindamycin", "correct": false}], "correct_answer": "B. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:664px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antibiotics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Broad spectrum </strong></p>\n<p>Effective against a wide range of bacteria, including both <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">Gram-positive</span> and <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> organisms.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chloramphenicol (Option C)</strong></p>\n<br/>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pyogenic <span class=\"customMeta\" data-dictid=\"7d8f74eaae16927771928214d10c17\">meningitis</span> (Second line)</li>\n<li>Endophthalmitis</li>\n<li>Anaerobic infections</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tetracycline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chlamydia</li>\n<li>Bacillus anthrax</li>\n<li>Psittacosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clindamycin </strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ance</li>\n<li>Anaerobic infections</li>\n<li>Drug-resistant Malaria</li>\n<li>Toxoplasmosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intermediate spectrum</strong></p>\n<p>Typically, they cover <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">Gram-positive</span> or <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> bacteria, but not both extensively.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macrolides</p>\n<ul>\n<li><strong>Azithromycin </strong> <strong>(Option A)</strong></li>\n<li><strong>Erythromycin </strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atypical pneumonia</li>\n<li>Whooping cough</li>\n<li>Chlamydia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Narrow spectrum </strong></p>\n<p>Effective against a limited range of bacteria.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aminoglycoside</p>\n<ul>\n<li><strong>Streptomycin </strong></li>\n<li><strong>Amikacin</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tuberculosis</li>\n<li>Tularemia</li>\n<li>Neonatal sepsis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Linezolid</strong> <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Vancomycin-resistant MRSA.</li>\n<li>VRE.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Streptogramin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MRSA</li>\n<li>Penicillin-resistant <span class=\"customMeta\" data-dictid=\"9562e26acc16927771995a2028dd05\">streptococcus</span> pneumonia.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is NOT true regarding Chloramphenicol?", "options": [{"label": "A", "text": "It is metabolised via hepatic conjugation", "correct": false}, {"label": "B", "text": "It can cause dose-dependent marrow suppression", "correct": false}, {"label": "C", "text": "It can be safely used in neonates", "correct": true}, {"label": "D", "text": "Resistance occurs due to plasmid-mediated inactivation by bacteria.", "correct": false}], "correct_answer": "C. It can be safely used in neonates", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the 50s ribosomal subunit, preventing <span class=\"customMeta\" data-dictid=\"53172b32401692777195efbbb6b2e8\">peptide</span> chain elongation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Absorption &amp; Distribution</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapidly absorbed, has a high <span class=\"customMeta\" data-dictid=\"ee6800538c169277720292cf2d4f1c\">volume of distribution</span> (1 L/kg), has good <span class=\"customMeta\" data-dictid=\"123c47549916927771854892334fb9\">CSF</span> penetration, and freely penetrates bodily cavities.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excreted via <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> glucuronidation.<strong> (Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> of warfarin, cyclophosphamide, and phenytoin.</li>\n<li>Enhanced <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> by phenobarbitone, phenytoin, and rifampin.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Resistance Mechanisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Plasmid-mediated <span class=\"customMeta\" data-dictid=\"2f7bf58a321692777190e32a914615\">inactivation</span> by bacteria decreases <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> into bacteria. <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second line for <span class=\"customMeta\" data-dictid=\"f6332ef2d21692777196294f154e57\">pyogenic</span> meningitis, endophthalmitis, <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dose-dependent <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression.<strong> (Option B)</strong></li>\n<li>Dose-independent idiosyncratic reaction.</li>\n<li>Hypersensitivity.</li>\n<li>Grey baby syndrome.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old man with a history of multiple sexual partners comes to the clinic with an inguinal swelling. Physical examination findings are given below. What would be the drug of choice for this patient?", "options": [{"label": "A", "text": "Penicillin G", "correct": false}, {"label": "B", "text": "Doxycycline", "correct": true}, {"label": "C", "text": "Cefixime", "correct": false}, {"label": "D", "text": "Acyclovir", "correct": false}], "correct_answer": "B. Doxycycline", "question_images": ["https://image.prepladder.com/content/0ahOeOkJ9tjCi0YAEtEh1734438191.png"], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:662px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tetracycline </strong></p>\n<p><strong>Oxytetracycline </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Demeclocycline </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Doxycycline </strong></p>\n<p><strong>Minocycline </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potency </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Plasma protein binding </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>high</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6 - 12 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10 -16 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>18- 24 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alteration of gut flora</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Altered</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate alteration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Least alteration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phototoxicity </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Highest</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tooth discoloration is less marked</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diabetes insipidus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Doxycycline has low nephrotoxicity.</li>\n<li>Minocycline has 0totoxicity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses of Tetracyclines</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Chlamydial Infections</strong>: Urethritis, Endocervicitis, <span class=\"customMeta\" data-dictid=\"1df59c006c1692777191996da1b3f0\">Lymphogranuloma</span> venereum, <span class=\"customMeta\" data-dictid=\"2334b7498b1692777188fa8b2eee36\">granuloma</span> inguinale.</li>\n<li><strong>Atypical Pneumonia: </strong>Mycoplasma pneumonia, Psittacosis.</li>\n<li>Rickettsial Infections.</li>\n<li>Pleurodesis: <span class=\"customMeta\" data-dictid=\"d0f202322516927771863db87b76e7\">Doxycycline</span> for pneumothorax.</li>\n<li>H. pylori Infection: Part of quadruple therapy.</li>\n<li>Anthrax, Plague, Borrelia.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 26-year-old pregnant woman was treated with an antibiotic for chlamydia during-her 6th month of pregnancy. Nine months later, she delivered a healthy baby boy. As the child grew, he developed teeth resembling those in the provided image and had a short stature. Which antibiotic was most likely used?", "options": [{"label": "A", "text": "Tetracyclines", "correct": true}, {"label": "B", "text": "Amikacin", "correct": false}, {"label": "C", "text": "Chloramphenicol", "correct": false}, {"label": "D", "text": "Sulphonamide", "correct": false}], "correct_answer": "A. Tetracyclines", "question_images": ["https://image.prepladder.com/content/x0kqtwwFbmgSrBrUmQ5E1724221429.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> necrosis: seen in pregnancy</li>\n<li>Fanconi syndrome</li>\n<li>Photosensitivity</li>\n<li>Permanent discolouration of <span class=\"customMeta\" data-dictid=\"17dfb015d2169277720023db8fe9e5\">teeth</span> (due to in-utero exposure)</li>\n<li>Delayed growth</li>\n</ul>\n</td>\n<td style=\"vertical-align:top\">\n<ul>\n<li>Diabetes insipidus</li>\n<li>Rarely, ↑ ICP in children/pseudotumor cerebri</li>\n<li>Vestibulotoxic (minocycline)</li>\n<li>Exfoliative <span class=\"customMeta\" data-dictid=\"fedc53b3161692777186553c8f8d7d\">dermatitis</span> (hypersensitivity reaction)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antimicrobials is safe for use in neonates?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Chloramphenicol", "correct": false}, {"label": "C", "text": "Azithromycin", "correct": true}, {"label": "D", "text": "Sulfamethoxazole", "correct": false}], "correct_answer": "C. Azithromycin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"><strong>Azithromycin </strong></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Azithromycin inhibits bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit, <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with the <span class=\"customMeta\" data-dictid=\"3e53f6980f1692777187044dd3f9e7\">elongation</span> of the <span class=\"customMeta\" data-dictid=\"287fd897ad1692777196f583338128\">polypeptide</span> chain and ultimately halting bacterial growth.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Pharmacokinetics</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Excellent <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> penetration, allowing it to effectively target <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> pathogens. This <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> accumulation contributes to its prolonged half-life.</li>\n<li>Once-daily dosing</li>\n<li>Hepatic clearance</li>\n<li>does not cross the blood-brain barrier.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Respiratory Infections (e.g., <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (atypical), bronchitis)</li>\n<li>Genitourinary Infections (e.g., <span class=\"customMeta\" data-dictid=\"21e09b6e771692777184f66df5bf7a\">Chlamydia</span> trachomatis)</li>\n<li>Skin and Soft Tissue Infections (e.g., cellulitis)</li>\n<li>Other Infections (e.g., <span class=\"customMeta\" data-dictid=\"b913f965781692777194c867946afe\">otitis</span> media, pharyngitis)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> upset</li>\n<li>Abdominal pain</li>\n<li>Headache</li>\n<li>Dizziness</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:572px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Antimicrobials contraindicated in infants</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Erythromycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <span class=\"customMeta\" data-dictid=\"2cf4f27ae616927771895f410747ad\">hypertrophic pyloric stenosis</span> in neonates</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chloramphenicol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of grey baby syndrome in neonates due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> metabolism, leading to toxic levels of the drug.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sulfamethoxazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <span class=\"customMeta\" data-dictid=\"34fea2624516927771905a0047f439\">kernicterus</span> in neonates due to <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of <span class=\"customMeta\" data-dictid=\"2d60c5a677169277718325a811dcf1\">bilirubin</span> from albumin, increasing <span class=\"customMeta\" data-dictid=\"2d60c5a677169277718325a811dcf1\">bilirubin</span> levels in the brain.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antibiotics is commonly used in triple therapy to treat H. pylori infection?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Doxycycline", "correct": false}, {"label": "C", "text": "Azithromycin", "correct": false}, {"label": "D", "text": "Clarithromycin", "correct": true}], "correct_answer": "D. Clarithromycin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/rKnaYvgm8jdxRGNUDuMb1734943509.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clarithromycin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Upper and lower <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections, <span class=\"customMeta\" data-dictid=\"b913f965781692777194c867946afe\">otitis</span> media, whooping cough, <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> pneumonia, H. pylori eradication, <span class=\"customMeta\" data-dictid=\"7519fc85511692777191a7f67777eb\">MAC</span> infection in AIDS patients, other <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> mycobacterial diseases, and leprosy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gastric intolerance, <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> <span class=\"customMeta\" data-dictid=\"f3f80e5bee1692777188f6eb1c4005\">hearing loss</span> (at high doses), <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> dysfunction, <span class=\"customMeta\" data-dictid=\"a0a7196e3f169277719777de15ff29\">rhabdomyolysis</span> (rare), and CYP3A4 <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> lead to potential drug interactions.</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:595px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diseases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antibiotics used in the treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Borrelia, Leptospirosis, <span class=\"customMeta\" data-dictid=\"5a7131fc701692777184f7da847192\">Cholera</span> (Adults)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Doxycycline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cholera (Pregnant Women)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Azithromycin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>H.pylori</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clarithromycin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true regarding Erythromycin?", "options": [{"label": "A", "text": "Primarily eliminated through renal excretion.", "correct": false}, {"label": "B", "text": "Erythromycin is stable in an acidic environment.", "correct": false}, {"label": "C", "text": "Have a large volume of distribution, allowing for extensive tissue penetration.", "correct": true}, {"label": "D", "text": "Highly lipid-soluble, allowing for excellent penetration into the central nervous system", "correct": false}], "correct_answer": "C. Have a large volume of distribution, allowing for extensive tissue penetration.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Property</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Volume of distribution</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High</strong>, with extensive tissue penetration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acid stability</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unstable in <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> pH</strong> (why <span class=\"customMeta\" data-dictid=\"bb1d21b9cb16927771876507ac7d2f\">enteric-coated</span> or esterified forms are used)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Route of excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mainly <strong>hepatic</strong>, via bile</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CNS penetration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Poor</strong>, due to limited <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> solubility</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NKhxxTIpYzZ3kKveZk5l1748861379.mp3", "video": ""}, {"text": "A 45-year-old woman presents with severe diarrhoea and abdominal pain after recently being treated with an antibiotic for a skin infection. Stool tests confirm the presence of Clostridium difficile. Which of the following antibiotics is associated with the highest risk of causing pseudomembranous colitis in this clinical scenario?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Tetracycline", "correct": false}, {"label": "C", "text": "Clindamycin", "correct": true}, {"label": "D", "text": "Ciprofloxacin", "correct": false}], "correct_answer": "C. Clindamycin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:605px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clindamycin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosome.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum of Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effective against <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> cocci, <span class=\"customMeta\" data-dictid=\"27791cc8181692777184b363360a3c\">Clostridium</span> spp., Nocardia, Actinomyces, Toxoplasma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anaerobic and mixed infections, especially those caused by <span class=\"customMeta\" data-dictid=\"8cad4fab55169277718248f3657d0f\">Bacteroides</span> fragilis, can lead to conditions like <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> and <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> abscesses, lung abscesses, <span class=\"customMeta\" data-dictid=\"39f67d7dde16927771985d3952058d\">septic</span> abortion, and infections from <span class=\"customMeta\" data-dictid=\"55b31d659b16927771958a15837b10\">penetrating</span> injuries.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rashes, urticaria, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain.</li>\n<li>Liver damage</li>\n<li>Thrombophlebitis at the <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> site.</li>\n<li>Major concern: Pseudomembranous <span class=\"customMeta\" data-dictid=\"85d2909f961692777187ea2494afd9\">enterocolitis</span> due to <span class=\"customMeta\" data-dictid=\"27791cc8181692777184b363360a3c\">Clostridium</span> difficile superinfection, potentially fatal.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old patient with renal failure presents with a suspected Gram-positive bacterial infection. The patient's creatinine clearance is significantly reduced. Which antibiotic would be the most appropriate choice for this patient?", "options": [{"label": "A", "text": "Vancomycin", "correct": false}, {"label": "B", "text": "Ciprofloxacin", "correct": false}, {"label": "C", "text": "Gentamicin", "correct": false}, {"label": "D", "text": "Linezolid", "correct": true}], "correct_answer": "D. Linezolid", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Linezolid</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It inhibits bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 23S <span class=\"customMeta\" data-dictid=\"ff37e741eb1692777197a5d617b479\">ribosomal RNA</span> of the P site of 50S ribosomal subunit.</li>\n<li>It interferes with the formation of the <span class=\"customMeta\" data-dictid=\"6e71126f6416927772001715e3e3a0\">ternary</span> N-formylmethionyl-tRNA (tRNAf-Met)-70S <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> complex, preventing the <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of protein synthesis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum of Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gram-positive <span class=\"customMeta\" data-dictid=\"57640139fe169277718418f95ae49f\">cocci</span> (aerobic and anaerobic): MRSA, VRSA, VRE, Strep. viridans, Strep. pneumoniae</li>\n<li>Other sensitive bacteria: Clostridia, B. fragilis, M. tuberculosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Uncomplicated and complicated skin and soft tissue infections Hospital-acquired <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (HAPs)</li>\n<li>Bacteremia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and diarrhoea.</li>\n<li>Chorioretinitis</li>\n<li>Optic neuritis</li>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> (monitor <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> count)</li>\n<li>Caution is advised when used concurrently with <span class=\"customMeta\" data-dictid=\"0307bca2ef1692777191b7df13d4b3\">MAO</span> inhibitors due to the risk of <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> syndrome.</li>\n<li>Serotonin syndrome</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old woman with diabetes and chronic kidney disease is hospitalised for a severe diabetic foot infection, likely due to MRSA. The doctor is considering a Streptogramin antibiotic. Which of the following statements about Streptogramins is correct?", "options": [{"label": "A", "text": "Inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit.", "correct": true}, {"label": "B", "text": "Cover both Gram-positive and Gram-negative bacteria.", "correct": false}, {"label": "C", "text": "First-line therapy for community-acquired pneumonia.", "correct": false}, {"label": "D", "text": "The most common adverse effect is nephrotoxicity.", "correct": false}], "correct_answer": "A. Inhibit bacterial protein synthesis by binding to the 50S ribosomal subunit.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Quinupristin-Dalfopristin (used in fixed combination)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum of Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mainly <strong>Gram-positive cocci</strong> (MRSA, VRE faecium)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phlebitis</strong>, arthralgia, myalgia, elevated <span class=\"customMeta\" data-dictid=\"2d60c5a677169277718325a811dcf1\">bilirubin</span> (not nephrotoxicity)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily <strong>hepatic</strong> (safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> dysfunction)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old diabetic man presents with a severe UTI, showing high fever, chills, and dysuria. Urine culture reveals E. coli resistant to aminoglycosides and fluoroquinolones. What mechanism likely contributes to E. coli's resistance to aminoglycosides?", "options": [{"label": "A", "text": "Inactivation of the drug by bacterial enzymes", "correct": true}, {"label": "B", "text": "Alteration of the bacterial ribosomal binding site", "correct": false}, {"label": "C", "text": "Decreased uptake of the drug into bacterial cells", "correct": false}, {"label": "D", "text": "Formation of biofilms on mucosal surfaces", "correct": false}], "correct_answer": "A. Inactivation of the drug by bacterial enzymes", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aminoglycosides</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits bacterial protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 30S ribosomal subunit, causing misreading of mRNA.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Streptomycin, Gentamicin, Tobramycin, Amikacin, Neomycin, Netilmicin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Spectrum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> <span class=\"customMeta\" data-dictid=\"789c9dd31a16927771801dd2426384\">aerobic</span> bacteria; limited <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">Gram-positive</span> coverage. Includes <span class=\"customMeta\" data-dictid=\"dea08f9dd81692777196a5f62e6862\">Pseudomonas</span> aeruginosa, Enterobacteriaceae.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Serious <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">Gram-negative</span> infections (e.g., sepsis, pneumonia)</li>\n<li>Tuberculosis (Streptomycin)</li>\n<li>Endocarditis (Gentamicin in combination therapy)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Resistance mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enzymatic <span class=\"customMeta\" data-dictid=\"2f7bf58a321692777190e32a914615\">inactivation</span> by acetyltransferases, phosphotransferases, and nucleotidyltransferases.</li>\n<li>Alteration of the 30S ribosomal binding site.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which adverse effects are most commonly associated with aminoglycosides?", "options": [{"label": "A", "text": "Hepatotoxicity and hypoglycemia", "correct": false}, {"label": "B", "text": "Nephrotoxicity and ototoxicity", "correct": true}, {"label": "C", "text": "Cardiotoxicity and neutropenia", "correct": false}, {"label": "D", "text": "Pulmonary toxicity and hyperkalemia", "correct": false}], "correct_answer": "B. Nephrotoxicity and ototoxicity", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:722px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reversibility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Order</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ototoxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Damages hair cells (neurons projecting into endolymph).</li>\n<li>Cochlear damage leads to high-frequency hearing loss.</li>\n<li>Vestibular damage leads to imbalance, ataxia, vertigo.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irreversible.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neomycin &gt; <span class=\"customMeta\" data-dictid=\"29b51ba65b1692777181574e73b9ae\">Amikacin</span> &gt; Kanamycin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nephrotoxicity</strong><strong> </strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Damages <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> cells of <span class=\"customMeta\" data-dictid=\"32562f5afa1692777193c891837db9\">nephron</span> (PCT, DCT), leading to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> acidosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reversible.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neomycin &gt; <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">Gentamicin</span> &gt; Streptomycin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neuromuscular Blockade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits release of <span class=\"customMeta\" data-dictid=\"fba05f424716927771802b63f6c392\">ACh</span> and blocks Nm receptor, leading to muscle paralysis</li>\n<li>Contraindicated in <span class=\"customMeta\" data-dictid=\"6fa809ad22169277719323eaa30f1e\">Myasthenia</span> gravis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partially <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> with <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> salts.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neomycin &gt; <span class=\"customMeta\" data-dictid=\"39899c81f016927771991addbc683d\">Streptomycin</span> &gt; Tobramycin.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which antibiotics will be least helpful in treating Enterococcus faecium infection?", "options": [{"label": "A", "text": "Ampicillin", "correct": true}, {"label": "B", "text": "Linezolid", "correct": false}, {"label": "C", "text": "Daptomycin", "correct": false}, {"label": "D", "text": "Tigecycline", "correct": false}], "correct_answer": "A. Ampicillin", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:582px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action (MOA)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vancomycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the D-alanyl-D-alanine <span class=\"customMeta\" data-dictid=\"3592c189a51692777200caec77a0aa\">terminus</span> of <span class=\"customMeta\" data-dictid=\"97294d26a21692777184b7ddc59c4e\">cell wall</span> <span class=\"customMeta\" data-dictid=\"ae13cdc5c3169277719683e9f6bda5\">precursor</span> units.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Linezolid</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 50S ribosomal subunit.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Daptomycin</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes rapid depolarisation of bacterial <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> potential, inhibiting protein, DNA, and <span class=\"customMeta\" data-dictid=\"cc65bdc03f169277719726a675e8a7\">RNA</span> synthesis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nitrofurantoin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced by bacterial enzymes to <span class=\"customMeta\" data-dictid=\"092583d1b41692777197a506409267\">reactive</span> intermediates, altering or inactivating bacterial ribosomal proteins.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tigecycline</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by binding to the 30S ribosomal subunit.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old woman with COPD develops severe diarrhoea, abdominal cramps, and fever two weeks after being treated with ceftriaxone and clindamycin. Stool testing confirms Clostridioides difficile infection. An endoscopic image shows pseudomembranous colitis. Which antibiotic is the most appropriate for treating her condition?", "options": [{"label": "A", "text": "Metronidazole", "correct": false}, {"label": "B", "text": "Rifaximin", "correct": false}, {"label": "C", "text": "Fidaxomicin", "correct": true}, {"label": "D", "text": "Clindamycin", "correct": false}], "correct_answer": "C. Fidaxomicin", "question_images": ["https://image.prepladder.com/content/RgbkLOUyoA0BjECuMkPt1734438449.png"], "explanation_images": ["https://image.prepladder.com/content/b93P9dX3OHjF8h0eiDzk1724255317.png"], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:574px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs which increase the risk of Pseudomembranous colitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs useful in Pseudomembranous colitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clindamycin (highest risk)</li>\n<li>Cephalosporins (e.g., ceftriaxone)</li>\n<li>Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)</li>\n<li>Penicillins (e.g., ampicillin, amoxicillin)</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metronidazole (mild and <span class=\"customMeta\" data-dictid=\"318e52e4751692777195acbcdf4551\">pediatric</span> cases)</li>\n<li>Vancomycin</li>\n<li>Fidaxomicin</li>\n<li>Rifaximin</li>\n<li>Bezlotoxumab (new FDA approved drug)</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents with a fever and a red, tender, swollen left knee, which started two days ago. He was recently diagnosed with hypertension and started on hydrochlorothiazide. Immediate joint aspiration is done, and the microscopic picture is given below. Which of the following is the most appropriate initial management?", "options": [{"label": "A", "text": "Probenecid", "correct": false}, {"label": "B", "text": "Naproxen", "correct": true}, {"label": "C", "text": "Sulfinpyrazone", "correct": false}, {"label": "D", "text": "Febuxostat", "correct": false}], "correct_answer": "B. Naproxen", "question_images": ["https://image.prepladder.com/content/Z5E1meTIhqrkpbsE3Tza1724235007.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WeH8XrdjMhDQ7vbiZ8xv1747225744.mp3", "video": ""}, {"text": "Which of the following drugs treats an acute episode of gout by binding to synovial tubulin thus inhibiting the migration of granulocytes into the joint ?", "options": [{"label": "A", "text": "Etoricoxib", "correct": false}, {"label": "B", "text": "Piroxicam", "correct": false}, {"label": "C", "text": "Prednisolone", "correct": false}, {"label": "D", "text": "Colchicine", "correct": true}], "correct_answer": "D. Colchicine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/TO8EPmGoc0FjSEyUNkoV1724235125.jpg"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/89bbLIbliHtyo08pMeiQ1747225870.mp3", "video": ""}, {"text": "Which of the following drugs is not used in the management of chronic hyperuricemia?", "options": [{"label": "A", "text": "Etoricoxib", "correct": true}, {"label": "B", "text": "Sulfinpyrazone", "correct": false}, {"label": "C", "text": "Probenecid", "correct": false}, {"label": "D", "text": "Febuxostat", "correct": false}], "correct_answer": "A. Etoricoxib", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/b7We4Uch0fyQ66Nt0zfl1747225968.mp3", "video": ""}, {"text": "A patient complains of persistent pain and stiffness over both his big toes and right knee over the past 2 years. X-ray of big toe showed deposition of uric acid crystals. Which of the following is the most appropriate drug of choice to reduce uric acid levels?", "options": [{"label": "A", "text": "Piroxicam", "correct": false}, {"label": "B", "text": "Allopurinol", "correct": true}, {"label": "C", "text": "Hydrocortisone", "correct": false}, {"label": "D", "text": "Etoricoxib", "correct": false}], "correct_answer": "B. Allopurinol", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/D1Y4vBdXjbeH09AMZg391747292600.mp3", "video": ""}, {"text": "All of the following about allopurinol are incorrect except?", "options": [{"label": "A", "text": "Allopurinol is long-acting than alloxanthine.", "correct": false}, {"label": "B", "text": "Allopurinol is largely bound to plasma proteins.", "correct": false}, {"label": "C", "text": "Allopurinol reduces the activity of azathioprine.", "correct": false}, {"label": "D", "text": "Allopurinol is contraindicated during lactation.", "correct": true}], "correct_answer": "D. Allopurinol is contraindicated during lactation.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XBSlxsspYi08lZFkfLPi1747292796.mp3", "video": ""}, {"text": "A 48-year-old man with a history of chronic gout presented with recurrent episodes of painful attacks despite being on allopurinol. His physician suggests a drug that inhibits the reabsorption of uric acid in the proximal tubules. Which of the following drugs uses this mechanism of action?", "options": [{"label": "A", "text": "Probenicid", "correct": true}, {"label": "B", "text": "Febuxostat", "correct": false}, {"label": "C", "text": "Rasburicase", "correct": false}, {"label": "D", "text": "Colchicine", "correct": false}], "correct_answer": "A. Probenicid", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Probenecid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uricosuric agent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits URAT1 <span class=\"customMeta\" data-dictid=\"850b296dd316927772005b651f6e87\">transporter</span> → ↓ <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> → ↑ excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> (under-excretors)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Febuxostat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> → ↓ <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid production</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic gout</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rasburicase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uricolytic agent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Converts <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid to <span class=\"customMeta\" data-dictid=\"eae976dfa31692777181804c2b20e7\">allantoin</span> (soluble)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumor <span class=\"customMeta\" data-dictid=\"803b5ed1c8169277719190b446ac83\">lysis</span> syndrome</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Colchicine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-inflammatory</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\">microtubule</span> <span class=\"customMeta\" data-dictid=\"1346ac97b61692777196b91eff8228\">polymerization</span> → ↓ <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> activity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> attacks</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZlPnv4rL5lKbV1SLZxGW1747292928.mp3", "video": ""}, {"text": "A 75-year-old male with a history of gout presents to the clinic with increased frequency of gout attacks. His daily medications include rosuvastatin, low-dose aspirin and losartan for hypertension. He has been advised to avoid certain medications that can exacerbate his gout. Which of the following drugs should be avoided in this patient?", "options": [{"label": "A", "text": "Allopurinol", "correct": false}, {"label": "B", "text": "Losartan", "correct": false}, {"label": "C", "text": "Aspirin", "correct": true}, {"label": "D", "text": "Rosuvastatin", "correct": false}], "correct_answer": "C. Aspirin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs Associated with Gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs causing gout</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs beneficial in gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mnemonic – PAINED</strong></p>\n<ul>\n<li><strong>P</strong>: Pyrazinamide</li>\n<li><strong>A: <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">Aspirin</span> (Normal dose &lt;2 gms)</strong></li>\n<li><strong>I</strong>: Immunosuppressive: Cyclosporine</li>\n<li><strong>N</strong>: Niacin</li>\n<li><strong>E</strong>: Ethambutol</li>\n<li><strong>D</strong>: <span class=\"customMeta\" data-dictid=\"82987dba8b16927771861f93f6d325\">Diuretic</span> like loop diuretics, thiazides</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mnemonic – FALSe</strong></p>\n<ul>\n<li><strong>F</strong>: Fenofibrate</li>\n<li><strong>A</strong>: <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">Aspirin</span> in <span class=\"customMeta\" data-dictid=\"03f2e372da169277720011bdaf60ac\">toxic dose</span> &gt;5 gm</li>\n<li><strong>L</strong>: Losartan<strong> (OPTION B)</strong></li>\n<li><strong>Se</strong>: <span class=\"customMeta\" data-dictid=\"2d286fa70b1692777199aba0434a49\">Statins</span> (Pravastatin, rosuvastatin) <strong>(OPTION D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong> for drug-induced gout: Continue the drug + Allopurinol.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jtEIk4hgQ0hrPcDFT9Ul1747295505.mp3", "video": ""}, {"text": "A 42-year-old female presented to the hospital with early morning stiffness in her joints for the last few weeks. She reports severe pain in her right wrist and left knee. Increased CRP levels are seen in laboratory testing. What is the most appropriate treatment for this condition?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "NSAIDs", "correct": true}, {"label": "C", "text": "Hydroxychloroquine", "correct": false}, {"label": "D", "text": "Colchicine", "correct": false}], "correct_answer": "B. NSAIDs", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:581px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment of <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">Rheumatoid</span> Arthritis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Acute arthritis</u></strong></p>\n\t\t\t \n\n\t\t\t<ol>\n<li><strong>Mild-moderate</strong></li>\n</ol>\n\t\t\t \n\n\t\t\t<ul>\n<li>DOC: <strong>NSAIDs(OPTION B)</strong></li>\n<li>All except <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> (Piroxicam, Indomethacin, Aspirin, Diclofenac, Celecoxib</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong> 2. Severe flare/ Resistant to NSAIDS</strong></p>\n<p> </p>\n<ul>\n<li>1-2 joints: <span class=\"customMeta\" data-dictid=\"f953c828ea16927771909cb3a51e36\">Intra-articular</span> corticosteroids (Prednisolone, Triamcinolone)</li>\n<li>&gt;2 joints: Oral prednisolone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Long-term <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> treatment </u></strong></p>\n\t\t\t \n\n\t\t\t<p><strong>DMARDs (Disease-modifying <span class=\"customMeta\" data-dictid=\"fc3fc706581692777181d901117e4a\">antirheumatic</span> drugs)</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>DOC: <strong>Methotrexate</strong> <strong>(OPTION A)</strong></li>\n<li>Alternate: Hydroxychloroquine, Sulfasalazine, <span class=\"customMeta\" data-dictid=\"f5c6632a3616927771907038875b57\">Infliximab</span> etc. <strong>(OPTION D)</strong></li>\n<li>Action begins after 1 month</li>\n<li>Not recommended for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> arthritis.</li>\n<li>Bridge therapy – Start with <span class=\"customMeta\" data-dictid=\"a3e96d80e9169277718551158bbcd4\">corticosteroid</span> and maintain the patient on DMARD.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WNrikGxTVHhXUZEfC2O91748073772.mp3", "video": ""}, {"text": "A 45-year-old female has been experiencing pain and stiffness in her wrists despite initial treatments. Her rheumatologist decides to start her on disease-modifying therapy (DMARDs). Which of the following statements incorrectly describes the mechanisms of action of the DMARDs? Methotrexate inhibits dihydrofolate reductase, reducing the production of DNA and RNA. Hydroxychloroquine inhibits T-cell activation and reduces the production of pro-inflammatory cytokines. Sulfasalazine is metabolised to 5-aminosalicylic acid (5-ASA), which reduces inflammation of joints in rheumatoid arthritis (RA) Leflunomide inhibits the synthesis of purines, leading to a reduction in lymphocyte proliferation. Infliximab is an oral DMARD that acts by inhibiting interleukin-6.", "options": [{"label": "A", "text": "3, 4 and 5", "correct": true}, {"label": "B", "text": "1, 3, 4, and 5", "correct": false}, {"label": "C", "text": "1, 4 and 5", "correct": false}, {"label": "D", "text": "3 and 4 only", "correct": false}], "correct_answer": "A. 3, 4 and 5", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>DMARD’s</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methotrexate (1) (anchor drug)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"0ac01cc0c31692777185cae5f28175\">cytokine</span> production, <span class=\"customMeta\" data-dictid=\"131fe589f71692777184dc879b32db\">chemotaxis</span> and cell mediated immune reaction.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hydroxychloroquine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Block <span class=\"customMeta\" data-dictid=\"c605d4126116927771916c2002638e\">lymphocyte</span> <span class=\"customMeta\" data-dictid=\"8eedb6cec61692777196a6a3b93d3f\">proliferation</span> like <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> but with longer action.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sulfasalazine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"9f0d9ed6991692777199114475f94b\">sulfapyridine</span> component blocks <span class=\"customMeta\" data-dictid=\"c605d4126116927771916c2002638e\">lymphocyte</span> proliferation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Leflunomide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits DHOLD (Dihydro <span class=\"customMeta\" data-dictid=\"7d967b32491692777194f89956fa15\">orotate</span> dehydrogenase) and <span class=\"customMeta\" data-dictid=\"e34386023d169277720036d8bccc88\">thymidylate</span> synthase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infliximab (I/V)</strong></p>\n<p>Certolizumab</p>\n<p>Adalimumab</p>\n<p>Golimumab</p>\n<p>Etanercept</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-TNF𝛼</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chloroquine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits IL1, IL6 TNF-Alpha in lymphocytes, reducing T cell activation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>7.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tocilizumab</p>\n<p>Sarilumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-IL-6</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>8.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rituximab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-CD-20</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>9.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anakinra</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-IL-1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abatacept</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recombinant CTLA4, inhibits CD80/86</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>11.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tofacitinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Janus <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> (JAK) inhibitors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>12.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Penicillamine</p>\n<p>Gold (Au)</p>\n<p>Azathioprine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"2748357f451692777191377abbe2a6\">macrophage</span> and decreases IL-1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>13.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Azathioprine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cleaved to 6-mercaptopurine (6MP) and <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <span class=\"customMeta\" data-dictid=\"c03d9c910716927771961a9a2609b5\">purine</span> synthesis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/53YUGaD8zMuJPfJ5xBGH1748074075.mp3", "video": ""}, {"text": "A 42-year-old female with a 3-year history of worsening joint pain presented to the clinic with early morning stiffness and swelling in her wrists. Her symptoms were not relieved with ibuprofen. A physical examination of the hands is shown. What is the most appropriate first-line treatment for her condition?", "options": [{"label": "A", "text": "Hydroxychloroquine", "correct": false}, {"label": "B", "text": "Sulfasalazine", "correct": false}, {"label": "C", "text": "Methotrexate", "correct": true}, {"label": "D", "text": "Colchicine", "correct": false}], "correct_answer": "C. Methotrexate", "question_images": ["https://image.prepladder.com/content/I0i59EyLfNe4C6w5tIg41724235228.png"], "explanation_images": ["https://image.prepladder.com/content/fPqFV6g1tINkYfmHQIkg1724235295.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lTYQfyqAmWIWuDNlEM1B1748074247.mp3", "video": ""}, {"text": "A 52-year-old female patient with a known case of rheumatoid arthritis for 5 years presents to the clinic with complaints of nausea, fatigue, mouth ulcers and an unusual rash on her legs. She has been on a stable regimen of DMARDs for the past few years. Laboratory investigations reveal a decreased Hb level, elevated liver enzymes, and mild leukopenia. Which drug is most likely responsible for her current symptoms?", "options": [{"label": "A", "text": "Hydroxychloroquine", "correct": false}, {"label": "B", "text": "Sulfasalazine", "correct": false}, {"label": "C", "text": "Methotrexate", "correct": true}, {"label": "D", "text": "Penicillamine", "correct": false}], "correct_answer": "C. Methotrexate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ilXX5yzMOk79V7uXF3Li1748074635.mp3", "video": ""}, {"text": "A 52-year-old female with a 10-year history of rheumatoid arthritis has been on certain drug therapy for the past 5 years. She recently underwent an ophthalmological examination, where the ophthalmologist noted the presence of the following condition. What is the maximum recommended daily dose of the drug (in mg/kg) that is considered safe to minimise the risk of developing this condition?", "options": [{"label": "A", "text": "2.5 mg/kg", "correct": false}, {"label": "B", "text": "5 mg/kg", "correct": true}, {"label": "C", "text": "6.5 mg/kg", "correct": false}, {"label": "D", "text": "10 mg/kg", "correct": false}], "correct_answer": "B. 5 mg/kg", "question_images": ["https://image.prepladder.com/content/EzlmrHcJbA3fvf3Pggtb1724235388.png"], "explanation_images": ["https://image.prepladder.com/content/TUv9nvz0q5vYZ2rQxlR71724235465.png", "https://image.prepladder.com/content/QDJvj2g5BDaOFMpteoTu1724235469.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align:center\"><strong>Hydroxychloroquine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Hydroxychloroquine⟶ <span class=\"customMeta\" data-dictid=\"a7f502e35b1692777191b110a4b679\">Lysosome</span> Accumulation ⟶ ↑ Lysosomal pH ⟶ Inhibits <span class=\"customMeta\" data-dictid=\"782b31281a1692777181708484c1d1\">Antigen</span> Processing ⟶ ↓ Antigen-MHC Presentation ⟶ ↓ T-Cell <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">Activation</span> ⟶ Inhibits TLRs ⟶ ↓ Pro-inflammatory Cytokines ⟶ ↓ <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> in RA.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Rheumatoid arthritis.</li>\n<li>Systemic <span class=\"customMeta\" data-dictid=\"ccd536a9071692777191f53538ca30\">lupus</span> erythematosus (SLE).</li>\n<li>Prevention and treatment of malaria.</li>\n<li>Autoimmune diseases like Sjögren's syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Gastrointestinal (nausea, vomiting, diarrhoea).</li>\n<li>Dermatological (rash, <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> changes).</li>\n<li>Ocular toxicity:\n\t\t\t\t<ul>\n<li>Vortex <span class=\"customMeta\" data-dictid=\"05446ed9961692777190f3aa32fb8f\">keratopathy</span> (cornea verticallata).</li>\n<li>Posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract.</li>\n<li>Bull’s eye <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (deposits like <span class=\"customMeta\" data-dictid=\"9bb62139a81692777184648bfef564\">concentric</span> rings in the retina).</li>\n</ul>\n</li>\n<li>Cardiovascular (cardiomyopathy, QT prolongation).</li>\n<li>Neurological (headache, dizziness).</li>\n<li>Hematologic (anaemia, leukopenia).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Additional Info</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Regular ophthalmologic examinations to monitor for <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> toxicity.</li>\n<li>Maximum safe dose of hydroxychloroquine to minimise the risk of bull's-eye maculopathy, is recommended to be <strong>5 mg/kg of real body weight per day.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GRwOEVDHHGhTKJb9LAhn1748074780.mp3", "video": ""}, {"text": "A 33-year-old male patient with rheumatoid arthritis (RA) has been undergoing treatment with methotrexate for the past two years. Despite the treatment, his disease activity has worsened, prompting the addition of a newer drug. Six months later, he got married, and subsequently, the couple faced difficulty conceiving, which was attributed to the new medication. Which of the following drugs is most likely responsible?", "options": [{"label": "A", "text": "Hydroxychloroquine", "correct": false}, {"label": "B", "text": "Sulfasalazine", "correct": true}, {"label": "C", "text": "Leflunomide", "correct": false}, {"label": "D", "text": "Etanercept", "correct": false}], "correct_answer": "B. Sulfasalazine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align:center\"><strong>Sulfasalazine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Sulfasalazine⟶ Active Metabolites ⟶ Inhibits Cyclooxygenase/Lipoxygenase ⟶ ↓ Prostaglandins/Leukotrienes ⟶ ↓ <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> in GI <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">Tract</span> and Joints + <span class=\"customMeta\" data-dictid=\"1498582e511692777189763b4befe0\">Immunomodulation</span> + <span class=\"customMeta\" data-dictid=\"78d28b340916927771810a3fffeb0a\">Antimicrobial</span> Effects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>IBD <span class=\"customMeta\" data-dictid=\"b118cf61a016927772018a179057ef\">ulcerative</span> <span class=\"customMeta\" data-dictid=\"e6955110f21692777184d2090a400c\">colitis</span> and Crohn's disease.</li>\n<li>Rheumatoid arthritis.</li>\n<li>Juvenile <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> arthritis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Gastrointestinal( nausea, vomiting, diarrhea).</li>\n<li>Headache.</li>\n<li>Rash.</li>\n<li>Blood disorders like <span class=\"customMeta\" data-dictid=\"dc24e08a2816927771910356dd6dd7\">leukopenia</span> and thrombocytopenia.</li>\n<li>Liver dysfunction.</li>\n<li>Reversible <span class=\"customMeta\" data-dictid=\"e259c6641e1692777190c1be1c1842\">infertility</span> in males (<strong>oligospermia</strong>).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Additional Info</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Administered cautiously in patients with known <span class=\"customMeta\" data-dictid=\"e6a50302661692777199484845ac1d\">sulfa</span> allergies.</li>\n<li>Monitoring of blood counts and liver function is recommended during therapy.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/R1e4FLq6VeuHMd0IwlLX1748074920.mp3", "video": ""}, {"text": "Match the following Biologicals with their respective MOA. BIOLOGICALS MOA a) Rituximab i) Anti-TNFα b) Anakinra ii) Anti-IL6 c) Infliximab iii) Anti-IL1 d) Tocilizumab iv) CD20", "options": [{"label": "A", "text": "a-iii, b-iv, c-ii, d-i", "correct": false}, {"label": "B", "text": "a-iv, b-i, c-ii, d-iii", "correct": false}, {"label": "C", "text": "a-iv, b-iii, c-i, d-ii", "correct": true}, {"label": "D", "text": "a-iii, b-ii, c-i, d-iv", "correct": false}], "correct_answer": "C. a-iv, b-iii, c-i, d-ii", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align:center\"><strong>Mechanism of Action (MOA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align:center\"><strong>Biological Drug</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>TNF-alpha inhibitor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li><strong>Adalimumab</strong></li>\n<li>Etanercept</li>\n<li>Infliximab</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>IL-6 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li><strong>Tocilizumab</strong></li>\n<li>Sarilumab</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>CD20-</strong>directed cytolytic <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> antibody</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li><strong>Rituximab</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>CTLA-4 Ig <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> protein</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li>Abatacept</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>IL-1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<ul>\n<li><strong>Anakinra</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TaPJdaZZWuseJIvNr2uP1748075212.mp3", "video": ""}, {"text": "Which of the following is not a Janus kinase (JAK) inhibitor?", "options": [{"label": "A", "text": "Baricitinib", "correct": false}, {"label": "B", "text": "Upadacitinib", "correct": false}, {"label": "C", "text": "Tofacitinib", "correct": false}, {"label": "D", "text": "Alectinib", "correct": true}], "correct_answer": "D. Alectinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p style=\"text-align:center\"><strong>Janus <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> (JAK) inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<ul>\n<li><strong>Baricitinib (Option A)</strong></li>\n<li><strong>Upadacitinib (Option B)</strong></li>\n<li><strong>Tofacitinib (Option C</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>JAK Inhibitor⟶ Inhibits JAKs ⟶ <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">Blockade</span> of <span class=\"customMeta\" data-dictid=\"0ac01cc0c31692777185cae5f28175\">Cytokine</span> <span class=\"customMeta\" data-dictid=\"f9016f36fd1692777198b0fd5e9c6d\">Signaling</span> ⟶ ↓ <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">Inflammatory</span> Mediators ⟶ ↓ <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> in GI <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">Tract</span> and Joints + Immunomodulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mnemonic: “<strong>RAJPUT</strong>”</p>\n<ul>\n<li><strong>R</strong>heumatoid Arthritis</li>\n<li><strong>A</strong>nkylosing Spondylitis</li>\n<li><strong>J</strong>uvenile <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">Idiopathic</span> Arthritis</li>\n<li><strong>P</strong>soriatic Arthritis</li>\n<li><strong>U</strong>lcerative <span class=\"customMeta\" data-dictid=\"e6955110f21692777184d2090a400c\">Colitis</span> is</li>\n<li><strong>T</strong>ofacitinib</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Increased risk of infections</li>\n<li>Liver <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> elevation</li>\n<li>Gastrointestinal disturbances</li>\n<li>Headache</li>\n<li>Fatigue</li>\n<li>Increased cholesterol levels</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qTEXKa6AGBgIN3cVelog1748075049.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 32-year-old patient presents with symptoms of seasonal allergies, including sneezing, rhinorrhea, and itchy eyes. The patient has a history of performing tasks requiring alertness throughout the day. Which antihistamines would be the most suitable choice for this patient?", "options": [{"label": "A", "text": "Diphenhydramine", "correct": false}, {"label": "B", "text": "Fexofenadine", "correct": true}, {"label": "C", "text": "Hydroxyzine", "correct": false}, {"label": "D", "text": "Loratadine", "correct": false}], "correct_answer": "B. Fexofenadine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:611px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generalised Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1st Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diphenhydramine</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, drowsiness, dry mouth, blurred vision</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy symptoms, Insomnia, Motion sickness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chlorpheniramine</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, drowsiness, dry mouth</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hydroxyzine </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anxiety, <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">Allergy</span> symptoms, Pruritus</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2nd Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Loratadine</strong><strong> </strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal sedation, dry mouth</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy symptoms, Urticaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cetirizine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy symptoms, Itchiness, Urticaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fexofenadine</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-sedating, minimal side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy symptoms, Chronic <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> urticaria</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9ys2En4JvH8ckrEQyeo51747223708.mp3", "video": ""}, {"text": "Which prostaglandin analogue is not used to conduct MTP (medical abortion) in the pregnancy?", "options": [{"label": "A", "text": "Misoprostol", "correct": false}, {"label": "B", "text": "Dinoprostone", "correct": false}, {"label": "C", "text": "Carboprost", "correct": false}, {"label": "D", "text": "Latanoprost", "correct": true}], "correct_answer": "D. Latanoprost", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DOC:</strong> Misoprostol 400µg, 48 hours after 200 mg of <span class=\"customMeta\" data-dictid=\"f9a7fe348e16927771921ce2ada3b2\">Mifepristone</span> administration.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CLASS</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DRUG</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACTION</strong></p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PGE1 (Option A)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Misoprostol, Gemeprost</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>The <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> expels the abortus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PGE2 (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dinoprostone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PGF2 <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carboprost, Dinoprost</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-progesterone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mifepristone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It makes the <span class=\"customMeta\" data-dictid=\"421fecf0e21692777202704942ac48\">fetus</span> non-viable.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-metabolite</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Methotrexate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can be used instead of mifepristone.</p>\n<p>Not recommended as it has a higher chance of incomplete abortion.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Jz2zofjK9zvPdjzwWuxc1747225152.mp3", "video": ""}, {"text": "In a 35-year-old woman at 40 weeks gestation presenting with an unripe cervix and scheduled for induction, what is the preferred subtype of prostaglandin for cervical ripening in preparation for labour?", "options": [{"label": "A", "text": "PGE2", "correct": true}, {"label": "B", "text": "PGE1", "correct": false}, {"label": "C", "text": "PGF2𝛂", "correct": false}, {"label": "D", "text": "PGI2", "correct": false}], "correct_answer": "A. PGE2", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prostaglandin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preparation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PGE1</strong> <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Misoprostol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NSAID-induced <span class=\"customMeta\" data-dictid=\"f6768ff15f1692777195a493cad3a9\">peptic</span> ulcer</p>\n<p>1st <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> <span class=\"customMeta\" data-dictid=\"eb06d1383216927771938c9eadb451\">MTP</span> abortion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alprostadil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erectile <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (cavernosal injection)</p>\n<p>Critical limb ischemia</p>\n<p>Open <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lubiprostone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irritable <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gemeprost</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> <span class=\"customMeta\" data-dictid=\"eb06d1383216927771938c9eadb451\">MTP</span> abortion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PGE2 <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dinoprostone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> ripening (Vaginal)</p>\n<p>Induction of labour</p>\n<p>Medical abortion</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PGF2𝛂<strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dinoprost</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Medical abortion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carboprost</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Resistant <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</p>\n<p>Medical abortion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Travoprost</p>\n<p>Latanoprost</p>\n<p>Bimatoprost</p>\n<p>Tafluprost</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Topical <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> for treatment of Glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PGI2 <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Iloprost</p>\n<p>Epoprostenol</p>\n<p>Treprostinil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pulmonary <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> (via <span class=\"customMeta\" data-dictid=\"0b1500fcd816927771900b59d16bde\">inhalation</span> route)</p>\n<p>As an <span class=\"customMeta\" data-dictid=\"257da9409416927771815e64ee5df1\">antiplatelet</span> during hemodialysis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0cTxo0CSa9MuFFYKPN1V1747224964.mp3", "video": ""}, {"text": "Match the following anti-inflammatory drugs with their mechanism of action. 1) Corticosteroid a) Cyclooxygenase inhibition 2) NSAIDs b) Lipoxygenase inhibition 3) Zileuton c) Phospholipase A 2 inhibition 4) Licofelone d) Platelet-activating receptor blocker 5) Apafant e) COX + LOX inhibition", "options": [{"label": "A", "text": "1-e, 2-a, 3-c, 4-b, 5-d", "correct": false}, {"label": "B", "text": "1-c, 2-a, 3-b, 4-e, 5-d", "correct": true}, {"label": "C", "text": "1-c, 2-e, 3-a, 4-d, 5-b", "correct": false}, {"label": "D", "text": "1-b, 2-c, 3-d, 4-a, 5-e", "correct": false}], "correct_answer": "B. 1-c, 2-a, 3-b, 4-e, 5-d", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/P9o2Z7WbUnyKvBYi2RZG1724234408.jpg"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:680px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"b3c0aa468916927771955a8c6d6998\">phospholipase</span> A2 enzyme, thus reducing the production of arachidonic acid.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most effective anti-inflammatory.</li>\n<li>Long-term usage causes Cushing syndrome.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NSAIDs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It blocks the <span class=\"customMeta\" data-dictid=\"ebd6f6186316927771854d3b6d65be\">cyclooxygenase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> and inhibits the conversion of <span class=\"customMeta\" data-dictid=\"403abe852c169277718297dd131d29\">arachidonic acid</span> to prostaglandins.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used in Gout, arthritis, <span class=\"customMeta\" data-dictid=\"09b955b4f91692777193bd4080e7fc\">musculoskeletal</span> pain, <span class=\"customMeta\" data-dictid=\"6fab9041ff1692777186e2eea4c0b2\">dysmenorrhea</span> etc</li>\n<li>Long-term use can cause <span class=\"customMeta\" data-dictid=\"7861e10657169277718815c2f42a75\">gastritis</span> and <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zileuton</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"47ba532e59169277719150eced0ed6\">5-lipoxygenase</span> enzyme.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Asthma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Licofelone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks both <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> and LOX enzymes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Controls <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> in osteoarthritis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Apafant</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks platelet-activating receptor.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Controls <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> pancreatitis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TnpqR1r7Eqp8ehIIavJk1747224863.mp3", "video": ""}, {"text": "A 32-year-old female with a known diagnosis of hereditary angioedema (HAE) presents to the ER with facial swelling and difficulty breathing. She reports that the symptoms started suddenly and have progressively worsened. Which drug can be used as a bradykinin B2 receptor blocker to treat the patient?", "options": [{"label": "A", "text": "Icatibant", "correct": true}, {"label": "B", "text": "Lanadelumab", "correct": false}, {"label": "C", "text": "Berotralstat", "correct": false}, {"label": "D", "text": "Ecallantide", "correct": false}], "correct_answer": "A. Icatibant", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qgwo8t3Memt8FReW76dO1724231344.jpg"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:689px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prophylaxis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drug of choice: <span class=\"customMeta\" data-dictid=\"d8f88626401692777185bbeda70317\">Danazol</span> (increases <span class=\"customMeta\" data-dictid=\"141f155d5016927771830be359c0e1\">C1 esterase</span> production)</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Alternatives: <span class=\"customMeta\" data-dictid=\"4d65ae39e016927771908d9ca58368\">Kallikrein</span> antagonists\n\t\t\t\t<ul>\n<li>Lanadelumab: <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">Monoclonal</span> <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> against <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> <span class=\"customMeta\" data-dictid=\"4d65ae39e016927771908d9ca58368\">kallikrein</span> <strong>(Option B)</strong></li>\n<li>Berotralstat: <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">Plasma</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> <strong>(Option C)</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drug of choice: <span class=\"customMeta\" data-dictid=\"141f155d5016927771830be359c0e1\">C1 esterase</span> inhibitor.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Alternatives:</p>\n<ul>\n<li>Kallikrein antagonist\n\t\t\t\t<ul>\n<li>Ecallantide: Potent <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> inhibitor<strong> (Option D)</strong></li>\n</ul>\n</li>\n<li>Bradykinin B2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist\n\t\t\t\t<ul>\n<li>Icatibant</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/G2gqAsuB5NOvD2UJ76nt1747224624.mp3", "video": ""}, {"text": "Cimetidine can reduce the effectiveness of ketoconazole. Which of the following mechanisms explain this interaction? Cimetidine decreases gastric acid production, leading to reduced absorption of ketoconazole. Cimetidine delays gastric emptying, reducing the absorption rate of ketoconazole. Cimetidine increases gastric pH, leading to reduced solubility and absorption of ketoconazole. Cimetidine induces liver enzymes, leading to increased clearance of ketoconazole.", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 3", "correct": true}, {"label": "C", "text": "2, 3", "correct": false}, {"label": "D", "text": "2, 4", "correct": false}], "correct_answer": "B. 1, 3", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/evLHNNTFHlhqVXSwDP6M1747224448.mp3", "video": ""}, {"text": "A 55-year-old male patient is being treated for peptic ulcer disease and presents with symptoms of breast tenderness and decreased libido. His current medication includes an H2 blocker. Which of the following H2 blockers is most likely responsible for these antiandrogenic effects?", "options": [{"label": "A", "text": "Ranitidine", "correct": false}, {"label": "B", "text": "Famotidine", "correct": false}, {"label": "C", "text": "Cimetidine", "correct": true}, {"label": "D", "text": "Nizatidine", "correct": false}], "correct_answer": "C. Cimetidine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Zyi6ZIv4GEGh1gptAy6j1747224175.mp3", "video": ""}, {"text": "Which of the following drugs is known for its maximum antipruritic effect?", "options": [{"label": "A", "text": "Doxylamine", "correct": false}, {"label": "B", "text": "Meclizine", "correct": false}, {"label": "C", "text": "Hydroxyzine", "correct": true}, {"label": "D", "text": "Chlorpheniramine", "correct": false}], "correct_answer": "C. Hydroxyzine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:648px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antipruritic Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Doxylamine</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC for morning sickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks H1 <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treat <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> symptoms and used as a short-term sleep aid due to its <span class=\"customMeta\" data-dictid=\"dd4bbf3a1a16927771988e61c3d5e9\">sedative</span> effects</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Meclizine</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sea sickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild to moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks H1 <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> receptors and <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily used to prevent and treat nausea, vomiting, and <span class=\"customMeta\" data-dictid=\"21b3779eca1692777186ec4f369d76\">dizziness</span> caused by motion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hydroxyzine</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antipruritic, anxiolytic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Maximum</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks H1 <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> receptors and has central nervous system <span class=\"customMeta\" data-dictid=\"974aacc9c716927771867653a1dd71\">depressant</span> activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Strong <span class=\"customMeta\" data-dictid=\"b934c33cc21692777181f55e558ff3\">antihistamine</span> used for treating itching, anxiety and as a sedative.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chlorpheniramine</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergic reactions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild to moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks H1 <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Commonly used for allergic reactions like hay fever and hives. It is the only first-generation <span class=\"customMeta\" data-dictid=\"b934c33cc21692777181f55e558ff3\">antihistamine</span> that can be given during the day.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yVAyjzIAuO4b0iJbi6EW1747224025.mp3", "video": ""}, {"text": "A 50-year-old patient with a history of cardiac arrhythmias presents with symptoms of allergic rhinitis. The physician considers prescribing either terfenadine or fexofenadine for symptom relief. Which differentiating factors should be considered when selecting the appropriate antihistamine for this patient?", "options": [{"label": "A", "text": "Fexofenadine is more likely to cause sedation.", "correct": false}, {"label": "B", "text": "Fexofenadine is more potent than terfenadine.", "correct": false}, {"label": "C", "text": "Fexofenadine is less likely to cause cardiac toxicity.", "correct": true}, {"label": "D", "text": "Fexofenadine is more expensive than terfenadine.", "correct": false}], "correct_answer": "C. Fexofenadine is less likely to cause cardiac toxicity.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:654px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Terfenadine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fexofenadine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First-generation antihistamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second-generation antihistamine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiac toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Withdrawn due to risk of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias (e.g., Torsades <span class=\"customMeta\" data-dictid=\"233d458dd316927771854358419c86\">de</span> Pointes) when co-administered with CYP3A4 inhibitors.</p>\n<p>(Note: <strong>CAT</strong> drugs - <strong>Cisapride, Astemizole, </strong>and<strong> Terfenadine</strong> have been withdrawn due to cardiotoxicity).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generally considered safer with minimal risk of <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prone to interactions with CYP3A4 inhibitors.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less <span class=\"customMeta\" data-dictid=\"607476ab371692777196d0cb2f13bc\">prone</span> to interactions with CYP3A4 inhibitors.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CNS Penetration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Penetrates blood-brain barrier.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Poor <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> of the blood-brain barrier.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolism leads to a longer <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> and duration of action.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal metabolism, shorter half-life, and shorter duration of action.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sedative Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It may cause <span class=\"customMeta\" data-dictid=\"b81cee1b5f16927771987099f651a0\">sedation</span> and impair <span class=\"customMeta\" data-dictid=\"67a8159af716927771964aa6043ac2\">psychomotor</span> performance.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal <span class=\"customMeta\" data-dictid=\"b81cee1b5f16927771987099f651a0\">sedation</span> or <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> of <span class=\"customMeta\" data-dictid=\"67a8159af716927771964aa6043ac2\">psychomotor</span> performance.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LntGqmorSPxu1sgkoXOZ1747223851.mp3", "video": ""}, {"text": "Which of the following is an ionotropic receptor?", "options": [{"label": "A", "text": "5-HT1", "correct": false}, {"label": "B", "text": "5-HT2", "correct": false}, {"label": "C", "text": "5-HT3", "correct": true}, {"label": "D", "text": "5-HT4", "correct": false}], "correct_answer": "C. 5-HT3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT1</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT3</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT4-7</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subtypes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5HT-1A, 5HT-1B, 5HT-1D, 5HT-1E, 5HT-1F, 5HT-1P.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GPCR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GPCR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ionotropic ligand-gated</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GPCR</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"ff0f0a7e341692777198133f3861c7\">serotonergic</span> activity in the brain, and their <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> drugs are used in <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> and as anxiolytics.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mediate <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> and visceral smooth muscle contraction, <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> <span class=\"customMeta\" data-dictid=\"a00e90be0416927771803afbbf099b\">aggregation</span> and neuronal <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> in the brain.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elicit <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> effects like emesis, gut peristalsis, bradycardia, <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> hypotension, apnoea, pain, and itch.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mediate intestinal <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> and <span class=\"customMeta\" data-dictid=\"b51a3255901692777182fc797ec427\">augmentation</span> of peristalsis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hCQVxX1iReuyR4yg0S861747217904.mp3", "video": ""}, {"text": "A 35-year-old woman is experiencing severe allergic reactions after eating shellfish. Her doctor prescribes a medication to help manage these symptoms. Which histamine receptors are primarily involved in regulating the allergic response?", "options": [{"label": "A", "text": "H1 receptor", "correct": true}, {"label": "B", "text": "H2 receptor", "correct": false}, {"label": "C", "text": "H3 receptor", "correct": false}, {"label": "D", "text": "H4 receptor", "correct": false}], "correct_answer": "A. H1 receptor", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:622px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Functions</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Locations</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H1 <strong>(OptionA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Allergic responses</li>\n<li>Smooth muscle contraction</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> permeability</li>\n<li>Stimulation of <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> nerve endings.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Smooth muscle cells</li>\n<li>Endothelial cells</li>\n<li>Neurons</li>\n<li>Immune cells</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H2 <strong>(OptionB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastric acid secretion</li>\n<li>Airway <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> production</li>\n<li>Vascular permeability</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Parietal cells in the stomach lining.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H3 <strong>(OptionC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Neurotransmitter release modulation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Central nervous system (CNS)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H4 <strong>(OptionD)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Immune responses</li>\n<li>Chemotaxis</li>\n<li>Cytokine production</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mast cells</li>\n<li>Eosinophils</li>\n<li>T cells</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KZwaZPhEvzZ2LmTExRZF1747223562.mp3", "video": ""}, {"text": "A 35-year-old woman is experiencing severe nausea and vomiting after chemotherapy. Her doctor prescribes a medication to help manage these symptoms. Which of the following medications is most likely to be prescribed?", "options": [{"label": "A", "text": "Ondansetron", "correct": true}, {"label": "B", "text": "Metoclopramide", "correct": false}, {"label": "C", "text": "Cisapride", "correct": false}, {"label": "D", "text": "Tegaserod", "correct": false}], "correct_answer": "A. Ondansetron", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:670px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5HT-3 Antagonists (Anti-motility drugs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5HT-4 Agonists (Prokinetic drugs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Block 5HT-3 receptors in the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> and central nervous system.</li>\n<li>Decrease <span class=\"customMeta\" data-dictid=\"6043ec42cf169277719044e8ee3234\">intestinal motility</span> and secretion.</li>\n<li>Inhibit the <span class=\"customMeta\" data-dictid=\"64f968d2251692777184286bce1af6\">chemoreceptor</span> trigger zone (CTZ) in the area postrema, reducing <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Activate 5HT-4 receptors in the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> tract.</li>\n<li>Increase <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">motility</span> and secretion.</li>\n<li>Enhances the release of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> from <span class=\"customMeta\" data-dictid=\"85c304623c1692777187da4d1f1ee7\">enteric</span> neurons.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ondansetron <strong>(Option A)</strong></li>\n<li>Granisetron</li>\n<li>Dolasetron</li>\n<li>Palonosetron</li>\n<li>Alosetron</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metoclopramide <strong>(Option B)</strong></li>\n<li>Cisapride (withdrawn due to QT prolongation) <strong>(Option C)</strong></li>\n<li>Tegaserod (restricted use due to <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> risks) <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV)</li>\n<li>Postoperative <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV)</li>\n<li>Radiation-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (RINV)</li>\n<li>Irritable <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome with diarrhoea (IBS-D): Alosetron</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastroparesis</li>\n<li>Gastroesophageal <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> disease (GERD)</li>\n<li>Functional dyspepsia</li>\n<li>Chronic constipation</li>\n<li>Postoperative ileus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Headache</li>\n<li>Constipation</li>\n<li>Dizziness</li>\n<li>Fatigue</li>\n<li>Prolonged QT interval (rare)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diarrhea</li>\n<li>Abdominal pain</li>\n<li>Nausea</li>\n<li>Headache</li>\n<li>Prolonged QT interval (Cisapride, Tegaserod)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fCe7unEPzsGZgX3HEbmN1747223420.mp3", "video": ""}, {"text": "A 35-year-old woman has been experiencing frequent and severe migraines. Her doctor recommends a medication that blocks 5HT-2 receptors to help prevent these attacks. Which of the following medications is most likely to be prescribed?", "options": [{"label": "A", "text": "Ketanserin", "correct": false}, {"label": "B", "text": "Ritanserin", "correct": false}, {"label": "C", "text": "Quetiapine", "correct": false}, {"label": "D", "text": "Cyproheptadine", "correct": true}], "correct_answer": "D. Cyproheptadine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:518px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cyproheptadine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Migraine prophylaxis, antihistamine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methysergide </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Migraine and <span class=\"customMeta\" data-dictid=\"e6ff23d9681692777184d241190073\">cluster headache</span> prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pizotifen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Migraine prophylaxis, antihistamine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Quetiapine</strong> <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Schizophrenia, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ketanserin</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ritanserin</strong> <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Investigated for schizophrenia, depression, and sleep disorders</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/waNDLXZIn9oo4akB84p21747223306.mp3", "video": ""}, {"text": "A 28-year-old woman with a history of migraine without aura, currently on preventive medication, is planning to conceive. She seeks advice on safe medications for treating acute migraine attacks during pregnancy. Which of the following drugs is recommended?", "options": [{"label": "A", "text": "Sumatriptan", "correct": false}, {"label": "B", "text": "Acetaminophen", "correct": true}, {"label": "C", "text": "Flunarizine", "correct": false}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "B. Acetaminophen", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safety in Pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Comments</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First-line (acute)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acetaminophen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe in all trimesters</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> attack in pregnancy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Step-up (acute)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Codeine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use with caution</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May be added if <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> alone is ineffective</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caffeine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe in moderation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can be combined with <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> for enhanced effect</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metoclopramide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Relatively safe, some side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can help with <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> associated with migraine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rescue (acute)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sumatriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Considered safe based on human data</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most <span class=\"customMeta\" data-dictid=\"a9dcc16be01692777187410eac8a4a\">evidence-based</span> triptan; used when first-line fails</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pregnancy Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acetaminophen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe – DOC in pregnancy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can be used regularly for mild prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Propranolol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used cautiously in 2nd/3rd trimester</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most preferred beta-blocker; used when non-drug measures fail</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/euK3MMor81bTWR5ieWg41747223116.mp3", "video": ""}, {"text": "A 35-year-old woman presents to the emergency department with a severe migraine headache that has been ongoing for several hours. She reports that her headache is accompanied by nausea, photophobia, and phonophobia. She has tried over-the-counter pain relievers without relief. What medication would you prescribe to help alleviate her symptoms?", "options": [{"label": "A", "text": "Sumatriptan", "correct": true}, {"label": "B", "text": "Paracetamol", "correct": false}, {"label": "C", "text": "Telotristat", "correct": false}, {"label": "D", "text": "Morphine", "correct": false}], "correct_answer": "A. Sumatriptan", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"width:624px\">\n<tbody>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>It is a selective 5-HT1B/1D <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> that activates other subtypes of 5-HT1 receptors only at very high concentrations.</li>\n<li>Inhibits the release of <span class=\"customMeta\" data-dictid=\"cc4b4052651692777183edb479e5b9\">calcitonin</span> gene-related <span class=\"customMeta\" data-dictid=\"53172b32401692777195efbbb6b2e8\">peptide</span> (CGRP) and causes <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> vasoconstriction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Administration and Efficacy</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>It is administered at the onset of a <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> attack and is as effective and better tolerated than ergotamine.</li>\n<li>About 3/4 of patients obtain complete or significant relief within 2-3 hours.</li>\n<li>Available in various formulations such as Oral tablets, <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> sprays, Injections and Rectal suppositories.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>It is absorbed rapidly and completely after <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> injection, with an oral <span class=\"customMeta\" data-dictid=\"cf91922bb816927771839a51f2d1e6\">bioavailability</span> of only 15%.</li>\n<li>It is rapidly metabolised by MAO-A isoenzyme, and metabolites are excreted in urine, with an <span class=\"customMeta\" data-dictid=\"86c65ffa40169277718763f4072c2f\">elimination</span> <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> of approximately 2 hours.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-color:#000000; border-style:solid\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid\">\n<ul>\n<li>Common side effects include tightness in the head and chest, feeling of heat and other paresthesias in the limbs, dizziness, and weakness. These are usually mild and short-lasting but can be dose-related.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tv8ABJJMup0N6CB4M8Ek1745661298.mp3", "video": ""}, {"text": "Which of the following statements best describes the interaction between ergotamine and triptans in migraine treatment?", "options": [{"label": "A", "text": "Ergotamine and triptans have a synergistic effect, leading to enhanced vasoconstriction.", "correct": true}, {"label": "B", "text": "Ergotamine and triptans compete for the same receptor, leading to decreased efficacy of both drugs.", "correct": false}, {"label": "C", "text": "Ergotamine and triptans have no interaction and can be safely used together for migraine relief.", "correct": false}, {"label": "D", "text": "Concurrent use of ergotamine and triptans can lead to serotonin syndrome due to additive serotonin receptor agonism.", "correct": false}], "correct_answer": "A. Ergotamine and triptans have a synergistic effect, leading to enhanced vasoconstriction.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kfvrbKNmVjxYlOiCYDN01747223016.mp3", "video": ""}, {"text": "A 35-year-old woman presents with a history of recurrent headaches. She describes a severe throbbing headache on the right side of her head associated with nausea, vomiting, and sensitivity to light and sound. She has tried over-the-counter pain relievers without relief. Triptans are being considered. Which of the following is the fastest-acting oral triptan?", "options": [{"label": "A", "text": "Sumatriptan", "correct": false}, {"label": "B", "text": "Rizatriptan", "correct": true}, {"label": "C", "text": "Almotriptan", "correct": false}, {"label": "D", "text": "Zolmitriptan", "correct": false}], "correct_answer": "B. Rizatriptan", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Route of Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bioavailability</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Onset of Action (Oral)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Time to Peak Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Key Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rizatriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>45%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~30 minutes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1–1.5 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.5 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fastest-acting oral triptan</strong>; highly lipophilic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sumatriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral, Nasal, Subcutaneous</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>15% (oral)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>45–60 minutes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.5–2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2.5 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>SC <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> has fastest overall onset</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zolmitriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral, Nasal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>40%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~45 minutes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~1.5 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nasal <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> offers quicker relief</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Almotriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>70%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1–2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Good tolerability; slower onset</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eletriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30–60 minutes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~1.5–2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effective in moderate to severe migraine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Frovatriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>25%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2–4 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>26 hours</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Longest half-life</strong>; used for <span class=\"customMeta\" data-dictid=\"3a03cad6c616927771925038b55989\">menstrual</span> migraine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Naratriptan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>70%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~1–2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2–3 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>6 hours</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fe</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OpBTnQQQyn7SN4k6B4gK1747222907.mp3", "video": ""}, {"text": "Which medication among the following acts via the mechanism of action of antagonising calcitonin gene-related peptide (CGRP) receptors?", "options": [{"label": "A", "text": "Sumatriptan", "correct": false}, {"label": "B", "text": "Rimegepant", "correct": true}, {"label": "C", "text": "Lasmiditan", "correct": false}, {"label": "D", "text": "Metoclopramide", "correct": false}], "correct_answer": "B. Rimegepant", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology of Migraine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Migraine is characterised by a pulsating <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> headache that <span class=\"customMeta\" data-dictid=\"89f5610ffd1692777184b03f1f88cc\">comes</span> in bouts lasting 4-48 hours and is associated with nausea, vomiting, sensitivity to light and sound, flashes of light, and vertigo.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>5th <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> (5-HT1F receptor)</li>\n</ul>\n<p> ↓</p>\n<p>Release of neurotransmitters like CGRP, neurokinin, <span class=\"customMeta\" data-dictid=\"b83d31a7d61692777193c128d13c7d\">Nitrous</span> Oxide, 5-HT</p>\n<p> ↓</p>\n<p>Dilation of meningeal vessels causing headache</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Triptans: Decrease the release of CGRP and cause vasoconstriction. E.g., Sumatriptan, Rizatriptan. <strong>(Option A ruled out)</strong></li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"6e1f8c026516927771919d54418520\">ligand</span> blockers: Eptinezumab, Fremanezumab</li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers: Rimegepant <strong>(Option B)</strong></li>\n<li>5-HT1F agonist: Causes <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of neuronal firing. E.g., Lasmiditan <strong>(Option C ruled out)</strong></li>\n<li>Ergot alkaloids: Vasoconstrictor. E.g., Ergotamine</li>\n<li>D2 Blockers: Metoclopramide <strong>(Option D ruled out)</strong></li>\n<li>Opioids and NSAIDs</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M8ryOKA6k0xjLYMo3nUi1747218017.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 28 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the following drugs to their mechanism of action: a) Aspirin i) Inhibits COX 3 b) Meloxicam ii) Inhibits COX 1 and 2 c) Parecoxib iii) Inhibits COX 2 &amp;gt; COX1 d) Paracetamol iv) Inhibits only COX 2", "options": [{"label": "A", "text": "a-ii, b-iii, c-iv, d-i", "correct": true}, {"label": "B", "text": "a-ii, b-iv, c-i, d-iii", "correct": false}, {"label": "C", "text": "a-i, b-iii, c-iv, d-ii", "correct": false}, {"label": "D", "text": "a-ii, b-i, c-iii, d-iv", "correct": false}], "correct_answer": "A. a-ii, b-iii, c-iv, d-i", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UXcajeweGoVFH8ESWk8X1724234567.jpg"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:408px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>a) Aspirin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ii) Inhibits <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 1 and 2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>b) Meloxicam</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>iii) Inhibits <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 2 &gt; COX1</p>\n<p>(Preferential <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 2 inhibitors)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>c) Parecoxib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>iv) Inhibits only <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 2</p>\n<p>(Selective <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 2 inhibitors)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>d) Paracetamol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>i) Inhibits <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 3</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"width:600px\">\n<thead>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</thead>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RQae5ZxMf8VT5EoLb5VU1734954792.mp3", "video": ""}, {"text": "Which of the following statements about NSAIDs is false?", "options": [{"label": "A", "text": "Used in IBD to control pain", "correct": true}, {"label": "B", "text": "Not used to treat neuropathic pain", "correct": false}, {"label": "C", "text": "Used for patent ductus arteriosus closure", "correct": false}, {"label": "D", "text": "Exerts anti-platelet action", "correct": false}], "correct_answer": "A. Used in IBD to control pain", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Uses of NSAIDs</strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p>NSAIDs are avoided in</p>\n</th>\n</tr>\n<tr>\n<th rowspan=\"6\" scope=\"col\" style=\"vertical-align:top\">\n<ul>\n<li style=\"text-align:left\">Analgesic (in all types of pain except neuropathic pain)</li>\n<li style=\"text-align:left\">Antipyretic</li>\n<li style=\"text-align:left\">Anti-inflammatory</li>\n<li style=\"text-align:left\">Antiplatelet</li>\n<li style=\"text-align:left\">Tocolytic</li>\n<li style=\"text-align:left\">Closure of PDA</li>\n</ul>\n</th>\n<th rowspan=\"6\" scope=\"col\" style=\"vertical-align:top\">\n<ul>\n<li style=\"text-align:left\">Pregnancy (as it causes <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">premature</span> <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> of <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus)</li>\n<li style=\"text-align:left\">Inflammatory <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> disease (IBD)</li>\n<li style=\"text-align:left\">Peptic <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> disease (PUD)</li>\n<li style=\"text-align:left\">Chronic <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease (CKD)</li>\n<li style=\"text-align:left\">Bleeding disorders</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Safest <span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\">NSAID</span> in these cases is paracetamol.</p>\n</th>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</thead>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/An0phSU60mSGMBEMpruL1746111506.mp3", "video": ""}, {"text": "A 65-year-old male patient with a history of hypertension and congestive heart failure presents with worsening lower extremity edema and shortness of breath. He has been on a regimen of furosemide for managing his fluid overload and NSAIDs for chronic arthritis pain. He has recently increased his dose of NSAIDs due to worsening pain. Which of the following is not a side effect of the drug responsible for failure of furosemide", "options": [{"label": "A", "text": "Gastric ulcer", "correct": false}, {"label": "B", "text": "Edema", "correct": false}, {"label": "C", "text": "Hypokalemia", "correct": true}, {"label": "D", "text": "Urticaria", "correct": false}], "correct_answer": "C. Hypokalemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:622px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional information</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gastrointestinal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea and vomiting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective COX-2 inhibitors: Less likely to cause GI side effects</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GI hemorrhage, erosion, ulcers <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to ↓prostaglandin synthesis, leading to loss of mucosal protection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hematological</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Platelet <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> → Increased bruising and <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> risk</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>From <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"96309dcb1c169277720072ad555473\">thromboxane</span> A2 activity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Renal dysfunction/failure</li>\n<li><strong>Reduction in <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> of <span class=\"customMeta\" data-dictid=\"1848b160c11692777191b60caaf622\">loop diuretics</span> &amp; antihypertensives</strong></li>\n<li>Salt and water retention</li>\n<li>Hyperkalemia <strong>(Option C)</strong></li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> necrosis</li>\n<li>Renal <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> necrosis</li>\n<li>Interstitial nephritis</li>\n<li>Analgesic nephropathy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Analgesic <span class=\"customMeta\" data-dictid=\"b06dd1c5181692777193f14f3ed7d7\">nephropathy</span> leads to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure with <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and chronic <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> nephritis, which is less common since the ban of phenacetin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiovascular</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Precipitate heart failure</li>\n<li>Edema <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevated liver enzymes</li>\n<li>Hepatic failure</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersensitivity</p>\n<br/>\n\t\t\t </td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urticaria <strong>(Option D)</strong></li>\n<li>Flushing</li>\n<li>Anaphylaxis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dermatological</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Steven-Johnson syndrome</li>\n<li>Photosensitivity</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7GqEHkJdYDvbZMvr0tTs1747217030.mp3", "video": ""}, {"text": "A 40-year-old male with a family history of colorectal cancer presents for a screening colonoscopy due to his increased risk. Colonoscopy confirms the presence of multiple adenomatous polyps in the patient's colon. Which drug is prescribed as chemoprevention?", "options": [{"label": "A", "text": "Mycophenolate mofetil", "correct": false}, {"label": "B", "text": "Aspirin", "correct": true}, {"label": "C", "text": "Methotrexate", "correct": false}, {"label": "D", "text": "All trans-retinoic acid", "correct": false}], "correct_answer": "B. Aspirin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:491px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low dose aspirin<br/>\n\t\t\t(40-300 mg/day)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiplatelet action</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Medium dose aspirin</p>\n<p>(300-2400 mg/day)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Analgesic and <span class=\"customMeta\" data-dictid=\"d085fa46531692777181b8038881f2\">Antipyretic</span> action</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High dose aspirin<br/>\n\t\t\t(2400-4000 mg/day)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-inflammatory action</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ifBEUr2WFTYZWjya4fM71747217154.mp3", "video": ""}, {"text": "A 9-year-old child presents with fever, myalgia and cough persisting for the past three days. The cough is non-productive and accompanied by mild nasal congestion. The child has a past medical history of eczema. She had a similar episode a year before and was treated with ibuprofen. Her mother has a known allergy to nonsteroidal anti-inflammatory drugs (NSAIDs). What is the reason this patient will be advised against taking aspirin?", "options": [{"label": "A", "text": "Cough", "correct": false}, {"label": "B", "text": "Patient age", "correct": true}, {"label": "C", "text": "Mother’s allergy", "correct": false}, {"label": "D", "text": "Eczema", "correct": false}], "correct_answer": "B. Patient age", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Why Contraindicated?</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NSAID allergy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cross-reactivity can cause severe allergic reactions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Asthma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <strong>bronchospasm</strong> due to NSAID-induced <span class=\"customMeta\" data-dictid=\"5a4fd169911692777191c1cb27b0d7\">leukotriene</span> shift</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Children with <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> illness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <strong>Reye syndrome</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gout</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aspirin impairs <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid excretion, worsening gout</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic liver disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can worsen <strong>hepatic injury</strong>, especially in high doses</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peptic ulcer/Gastritis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits prostaglandins → increased <strong>GI bleed</strong> risk</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bleeding disorders</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> <span class=\"customMeta\" data-dictid=\"a00e90be0416927771803afbbf099b\">aggregation</span> → ↑ risk of <strong>bleeding</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SJ9NP7zvHLwjQlNmCj2P1747217294.mp3", "video": ""}, {"text": "A 45-year-old woman presents with confusion, nausea, vomiting, and ringing in her ears. She has a history of chronic pain and admits to taking more aspirin than prescribed over the past few days. On examination, she is hyperventilating, her breath sounds are clear, and her vital signs include a BP of 110/70 mmHg, HR of 105 bpm, respiratory rate of 30/min, and temperature of 38.5°C (101.3°F). ABG analysis shows the following: pH: 7.45 | PaCO2: 25 mmHg | HCO3-: 15 mEq/L Which of the following best explains the mechanism behind the patient's acid-base disorder?", "options": [{"label": "A", "text": "Central respiratory stimulation and disruption of oxidative phosphorylation", "correct": true}, {"label": "B", "text": "Renal tubular damage and acid-base disorder", "correct": false}, {"label": "C", "text": "Increased renal bicarbonate production", "correct": false}, {"label": "D", "text": "Carbonic anhydrase inhibition", "correct": false}], "correct_answer": "A. Central respiratory stimulation and disruption of oxidative phosphorylation", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/nkJIloOL685EP2PEaudl1724234691.jpg"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/W78KtAptwTpEeCeuxDs61747217502.mp3", "video": ""}, {"text": "Which of the following is the drug of choice used in the closure of a PDA in premature infants?", "options": [{"label": "A", "text": "Indomethacin", "correct": false}, {"label": "B", "text": "Ibuprofen", "correct": true}, {"label": "C", "text": "Nimesulide", "correct": false}, {"label": "D", "text": "Mefenamic acid", "correct": false}], "correct_answer": "B. Ibuprofen", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Vhwa9juxtNmvLj6bvg2e1746258797.mp3", "video": ""}, {"text": "Which of the following NSAIDs is associated with a decreased risk of developing colon cancer?", "options": [{"label": "A", "text": "Sulindac", "correct": true}, {"label": "B", "text": "Diclofenac", "correct": false}, {"label": "C", "text": "Piroxicam", "correct": false}, {"label": "D", "text": "Ketorolac", "correct": false}], "correct_answer": "A. Sulindac", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vNHJB33svaqCZqN29NCp1747217603.mp3", "video": ""}, {"text": "A 65-year-old man with a history of chronic osteoarthritis presents to the emergency department with chest pain and shortness of breath. He has been taking an NSAID for pain management for the past few months. On examination, he appears diaphoretic and in distress. The ECG reveals ST-segment elevation in the anterior leads. Troponin levels are elevated. What is the most likely drug causing this patient's symptoms?", "options": [{"label": "A", "text": "Aspirin", "correct": false}, {"label": "B", "text": "Naproxen", "correct": false}, {"label": "C", "text": "Nefopam", "correct": false}, {"label": "D", "text": "Rofecoxib", "correct": true}], "correct_answer": "D. Rofecoxib", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pueJup6GuxHBezvcuw2T1745661020.mp3", "video": ""}, {"text": "A 25-year-old woman is brought to the emergency department by her roommate after intentionally ingesting a large quantity of paracetamol tablets. She reports feeling depressed and wanting to harm herself. On examination, she appears lethargic and complains of right upper quadrant abdominal pain. Laboratory tests reveal elevated liver enzymes. What is the primary pharmacological drug used in the treatment of paracetamol poisoning?", "options": [{"label": "A", "text": "N-Acetyl cysteine", "correct": true}, {"label": "B", "text": "Naloxone", "correct": false}, {"label": "C", "text": "Diazepam", "correct": false}, {"label": "D", "text": "Activated Charcoal", "correct": false}], "correct_answer": "A. N-Acetyl cysteine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kt17DK2Jbu40Y1uLuQmN1724234821.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:636px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early Stage </strong>(12–36 hours post-ingestion)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Later Stage</strong> (2–4 days post-ingestion)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Nausea, <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> &amp; <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain</li>\n<li>Liver tenderness</li>\n<li>↑ <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> transaminases</li>\n<li>No <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> of consciousness</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Right <span class=\"customMeta\" data-dictid=\"46ff8ef1ee16927771996bb1697129\">subcostal</span> pain with tender hepatomegaly</li>\n<li>Jaundice</li>\n<li>Coagulopathy</li>\n<li>Renal <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> or failure</li>\n<li>Hypoglycemia</li>\n<li>Hepatic encephalopathy</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/H14FYe9XRIIjqTdFe0Gs1747217780.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs is not used for the prophylaxis of migraine?", "options": [{"label": "A", "text": "Propranolol", "correct": false}, {"label": "B", "text": "Imipramine", "correct": false}, {"label": "C", "text": "Flutamide", "correct": true}, {"label": "D", "text": "Flunarizine", "correct": false}], "correct_answer": "C. Flutamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Drug for HIV induced lipodystrophy:", "options": [{"label": "A", "text": "Tesamorelin", "correct": true}, {"label": "B", "text": "Somatropin", "correct": false}, {"label": "C", "text": "Octreotide", "correct": false}, {"label": "D", "text": "Pegvisomant", "correct": false}], "correct_answer": "A. Tesamorelin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - T\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An elderly woman on treatment for migraine presents with chest pain. She has a previous history of angina/MI. Which of the following mechanisms of the prescribed drug for migraine might have caused this presentation?", "options": [{"label": "A", "text": "5-HT antagonist", "correct": false}, {"label": "B", "text": "5-HT agonist", "correct": true}, {"label": "C", "text": "Calcium Channel Blocker action", "correct": false}, {"label": "D", "text": "Nitric oxide-mediated vasodilation", "correct": false}], "correct_answer": "B. 5-HT agonist", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"ee9dfbd7b81692777188b432973e2e\"&gt;5-HT&lt;/span&gt; agonist</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Migraine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathophysiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Migraine is characterized by a pulsating <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> headache that <span class=\"customMeta\" data-dictid=\"89f5610ffd1692777184b03f1f88cc\">comes</span> in bouts lasting 4-48 hours and is associated with nausea, vomiting, sensitivity to light and sound, flashes of light, and vertigo.</li>\n<li>5th <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> (5-HT1F receptor) → Release of neurotransmitters like CGRP, neurokinin, <span class=\"customMeta\" data-dictid=\"b83d31a7d61692777193c128d13c7d\">Nitrous</span> Oxide, <span class=\"customMeta\" data-dictid=\"ee9dfbd7b81692777188b432973e2e\">5-HT</span> → <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">Dilation</span> of meningeal vessels causing headache</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Triptans: Decrease the release of CGRP and cause vasoconstriction. E.g., Sumatriptan, Rizatriptan.</li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"6e1f8c026516927771919d54418520\">ligand</span> blockers: Eptinezumab, Fremanezumab</li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers: Rimegepant</li>\n<li>5-HT1F agonist: Causes <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of neuronal firing. E.g., Lasmiditan</li>\n<li>Ergot alkaloids: Vasoconstrictor. E.g., Ergotamine</li>\n<li>D2 Blockers: Metoclopramide</li>\n<li>Opioids and NSAIDs</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is correct about the drugs used in Gout? A. Aspirin is not used as it decreases uric acid excretion B. Diclofenac is used as it concentrates in the joint C. Indomethacin is used as it acts by multiple pathways D. Aspirin is used as it is the most powerful NSAID", "options": [{"label": "A", "text": "A, B &amp;amp; C", "correct": true}, {"label": "B", "text": "A, B, C &amp;amp; D", "correct": false}, {"label": "C", "text": "A &amp;amp; B", "correct": false}, {"label": "D", "text": "Aspirin is used as it is the most powerful NSAIDC &amp;amp; D", "correct": false}], "correct_answer": "A. A, B &amp; C", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - A, B &amp;amp; C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Pegloticase is used in the management of?", "options": [{"label": "A", "text": "Chronic gout", "correct": true}, {"label": "B", "text": "Rheumatoid arthritis", "correct": false}, {"label": "C", "text": "Psoriatic arthritis", "correct": false}, {"label": "D", "text": "Calcium Pyrophosphate dehydrate deposition", "correct": false}], "correct_answer": "A. Chronic gout", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Drugs for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attack of gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>DOC- NSAIDS </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Except for <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and paracetamol</li>\n<li>Anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Colchicine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>MOA: <span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\">microtubule</span> inhibitor</strong></li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attacks of <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> and <span class=\"customMeta\" data-dictid=\"5dda3cc2ab1692777202b3b3c65bea\">familial</span> Mediterranean fever and is also the <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for karyotyping</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intra <span class=\"customMeta\" data-dictid=\"cd001152fe16927771823275439a2d\">articular</span> injections, avoid oral route</li>\n<li>Immunosuppressive and anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs for chronic gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include <span class=\"customMeta\" data-dictid=\"6337926de316927771812a6842721f\">Allopurinol</span> (DOC), Oxipurinol, <strong>Febuxostat</strong></li>\n<li><strong>MOA: Blocks <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> → Inhibits the conversion of <span class=\"customMeta\" data-dictid=\"304c30e55316927771895062b17e8b\">hypoxanthine</span> to <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid in the liver</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uric acid <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> enzyme</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include <strong>Pegloticase </strong>and Rasburicase</li>\n<li><strong>MOA: <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid is converted to <span class=\"customMeta\" data-dictid=\"eae976dfa31692777181804c2b20e7\">allantoin</span> and excreted in urine</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uricosuric agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include Probenecid, Benzbromaron, Sulfinpyrazone, <strong>Lesinurad</strong></li>\n<li><strong>MOA:</strong> <strong>Inhibit OATP transporter/URAT-1 in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> → inhibits <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid → increased <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid.</strong></li>\n</ul>\n<p> </p>\n<p>(OATP - Organic <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> transport protein, URAT-1 - <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid transporter)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication can be administered to reduce the frequency of future headache episodes in a 26-year-old female patient who experiences one-sided pulsating headaches accompanied by nausea, vomiting, and sensitivity to light and finds relief in a dimly lit environment?", "options": [{"label": "A", "text": "Propranolol", "correct": true}, {"label": "B", "text": "Alprazolam", "correct": false}, {"label": "C", "text": "Diazepam", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "A. Propranolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Propranolol</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Use of <span class=\"customMeta\" data-dictid=\"082f7143eb1692777196df69a3b6cb\">propranolol</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug of choice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Migraine prophylaxis</li>\n<li>Essential tremors</li>\n<li>Aortic <span class=\"customMeta\" data-dictid=\"e42da316b916927771860f0ba81c19\">dissection</span> if they also have hypertension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"8\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Other Uses</strong></p>\n</td>\n<td rowspan=\"8\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension-second-line drugs</li>\n<li>Stable angina</li>\n<li>Cardiac arrhythmias</li>\n<li>Congestive heart failure</li>\n<li>Thyrotoxicosis</li>\n<li>Hypertrophic <span class=\"customMeta\" data-dictid=\"6e6dd7aed216927771831ebdf9703c\">Cardiomyopathy</span> (Improve <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output).</li>\n<li>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> (Ml): Secondary <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of Ml and myocardial <span class=\"customMeta\" data-dictid=\"53d0f40d261692777198244a05ec72\">salvage</span> during evolution of Ml (decreases mortality).</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Acute management of <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> attack </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Triptans: Decrease the release of CGRP and cause vasoconstriction. E.g., Sumatriptan, Rizatriptan.</li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"6e1f8c026516927771919d54418520\">ligand</span> blockers: Eptinezumab, Fremanezumab</li>\n<li>CGRP <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers: Rimegepant</li>\n<li>5-HT1F agonist: Causes <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of neuronal firing. E.g., Lasmiditan</li>\n<li>Ergot alkaloids: Vasoconstrictor. E.g., Ergotamine</li>\n<li>D2 Blockers: Metoclopramide</li>\n<li>Opioids and NSAIDs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Prophylaxis of <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Propranolol (Beta-blocker, <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> prophylaxis).</li>\n<li>Flunarizine (Calcium channel blocker)</li>\n<li>Cyproheptadine: (Antihistamine that can help alleviate <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> symptoms).</li>\n<li>Candesartan: (Angiotensin II <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blocker).</li>\n<li>Clonidine</li>\n<li>Pizotifen (Serotonin <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> that can help reduce <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> frequency).</li>\n<li>Gabapentin, valproate, nortriptyline, and <span class=\"customMeta\" data-dictid=\"b4bc3f01b316927772005b04f0e449\">topiramate</span> are medications that can help manage <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> symptoms by releasing the <span class=\"customMeta\" data-dictid=\"e28fd027b416927771932bc23ba0a5\">neurotransmitter</span> GABA.</li>\n<li>Topiramate</li>\n<li>Methysergide (Manages <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> symptoms by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> receptors).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient took a drug for migraine treatment, following which there was numbness, and his hand appeared as below. What is the possible drug that was taken?", "options": [{"label": "A", "text": "Dihydroergotamine", "correct": true}, {"label": "B", "text": "Sumatriptan", "correct": false}, {"label": "C", "text": "Butorphanol", "correct": false}, {"label": "D", "text": "Aspirin", "correct": false}], "correct_answer": "A. Dihydroergotamine", "question_images": ["https://image.prepladder.com/notes/Ui0N5XPvVQOiQZDpD0p71747987306.png"], "explanation_images": [], "explanation": "<p>Correct Answer A - Dihydroergotamine</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dihydroergotamine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug class </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ergot alkaloids</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Partial <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> activity at <strong>5HT1B/1D receptors</strong> causes vasoconstriction, reducing migraine-associated inflammation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> attack</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Peripheral vasoconstriction\n\t\t\t\t<ul>\n<li>Manifest as numbness, tingling, and discolouration of the fingers, commonly <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as Raynaud's phenomenon.</li>\n<li>Discolouration of fingers - White <strong>→ </strong>Blue<strong>→</strong> Red</li>\n<li>It can lead to <span class=\"customMeta\" data-dictid=\"741c89cb18169277718889cfaafa53\">gangrene</span> of extremities and organs with end arteries.</li>\n</ul>\n</li>\n<li>Nausea and vomiting</li>\n<li>Paradoxical headache and dizziness</li>\n<li>Flushing</li>\n<li>Nasal congestion</li>\n<li>Chest pain</li>\n<li>Muscle pain</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is Zileuton's mechanism of action?", "options": [{"label": "A", "text": "Cycloxygenase inhibitor", "correct": false}, {"label": "B", "text": "5-Lipooxygenase inhibitor", "correct": true}, {"label": "C", "text": "5-Phosphodiesterase inhibitor", "correct": false}, {"label": "D", "text": "Prevents mass cell degradation", "correct": false}], "correct_answer": "B. 5-Lipooxygenase inhibitor", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/5BLyIwi3tE6PJSa67nTC1746697671.png", "https://image.prepladder.com/content/VLQib27XFS98wcDnNNfl1746697678.png"], "explanation": "<p>Correct Answer B - 5-Lipooxygenase inh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following DMARD uses require regular monitoring of visual acuity and fundus examination?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Hydroxychloroquine", "correct": true}, {"label": "C", "text": "Sulfasalazine", "correct": false}, {"label": "D", "text": "Leflunomide", "correct": false}], "correct_answer": "B. Hydroxychloroquine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/PGOYeAqYZqejT2N3lh5K1746697921.png", "https://image.prepladder.com/content/pEMGQhrMUKwPAGfszWtK1746697927.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Hydroxychloroquine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p><strong>MAO</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<p>Hydroxychloroquine⟶ Lysosome Accumulation ⟶ ↑ Lysosomal pH ⟶ Inhibits Antigen Processing ⟶ ↓ Antigen-MHC Presentation ⟶ ↓ T-Cell Activation ⟶ Inhibits TLRs ⟶ ↓ Pro-inflammatory Cytokines ⟶ ↓ Inflammation in RA</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Rheumatoid arthritis.</li>\n<li>Systemic <span class=\"customMeta\" data-dictid=\"ccd536a9071692777191f53538ca30\">lupus</span> erythematosus (SLE)</li>\n<li>Prevention and treatment of malaria</li>\n<li>Autoimmune diseases like Sjögren's syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Gastrointestinal (nausea, vomiting, diarrhoea)</li>\n<li>Dermatological (rash, <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> changes)</li>\n<li>Ocular toxicity:\n\t\t\t\t<ul>\n<li><strong>Vortex keratopathy</strong> (cornea verticallata)</li>\n<li><strong>Posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract</strong></li>\n<li><strong>Bull’s eye <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong>(deposits like <span class=\"customMeta\" data-dictid=\"9bb62139a81692777184648bfef564\">concentric</span> rings in the retina)</li>\n</ul>\n</li>\n<li>Cardiovascular (cardiomyopathy, QT prolongation)</li>\n<li>Neurological (headache, dizziness)</li>\n<li>Hematologic (anaemia, leukopenia)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p><strong>Note</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Regular ophthalmologic examinations to monitor for <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> toxicity.</li>\n<li>The maximum safe dose of hydroxychloroquine to minimise the risk of bull's-eye <span class=\"customMeta\" data-dictid=\"e2819a366f1692777191b1bf2bb04f\">maculopathy</span> is recommended to be <strong>5 mg/kg of real body weight per day.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Mechanism of action of allopurinol is?", "options": [{"label": "A", "text": "Xanthine oxidase inhibition", "correct": true}, {"label": "B", "text": "Recombinant uricase", "correct": false}, {"label": "C", "text": "Increase uric acid excretion", "correct": false}, {"label": "D", "text": "Decrease chemotaxis", "correct": false}], "correct_answer": "A. Xanthine oxidase inhibition", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\"&gt;Xanthine&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\"&gt;oxidase&lt;/span&gt; inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with chronic kidney disease underwent a nephrectomy. Which of the following can be administered as a postoperative analgesic in this patient?", "options": [{"label": "A", "text": "Naproxen", "correct": false}, {"label": "B", "text": "Indomethacin", "correct": false}, {"label": "C", "text": "Diclofenac", "correct": false}, {"label": "D", "text": "Acetaminophen", "correct": true}], "correct_answer": "D. Acetaminophen", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the initial treatment of choice for chronic gout in a 52-year-old woman with hypertension, type 2 diabetes mellitus, severe pain, and swelling in her left great toe, sporadic similar episodes over the past 3 years, and a daily intake of 6 beers?", "options": [{"label": "A", "text": "Allopurinol", "correct": true}, {"label": "B", "text": "Febuxostat", "correct": false}, {"label": "C", "text": "Probenecid", "correct": false}, {"label": "D", "text": "Sulfinpyrazone", "correct": false}], "correct_answer": "A. Allopurinol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Target</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td>Xanthine Oxidase</td>\n<td>\n<p>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">Oxidase</span> inhibitors</p>\n<ul>\n<li>Non-purine- Febuxostat (no-allergy)\n\t\t\t\t<ul>\n<li>Purine - <span class=\"customMeta\" data-dictid=\"6337926de316927771812a6842721f\">Allopurinol</span> (cause allergy)</li>\n</ul>\n</li>\n</ul>\n</td>\n<td>\n<p>Hyperuricemia</p>\n<p>Gout</p>\n</td>\n</tr>\n<tr>\n<td>Uric acid elimination </td>\n<td>\n<p>Uricosuric drugs:</p>\n<p>Probenecid, Sulfinpyrazone </p>\n<p>Benzbromarone, Lesinurad, and Losartan</p>\n</td>\n<td>Eliminating <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid through urine</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most suitable medication for alleviating the symptoms of a 56-year-old postmenopausal woman who has been experiencing worsening pain and swelling in her left knee for the past 6 months? She has a medical history of peptic ulcer disease and is currently taking cimetidine. On examination, palpable crepitus and restricted range of motion are observed in her left knee.", "options": [{"label": "A", "text": "Ketorolac", "correct": false}, {"label": "B", "text": "Etoricoxib", "correct": true}, {"label": "C", "text": "Piroxicam", "correct": false}, {"label": "D", "text": "Ibuprofen", "correct": false}], "correct_answer": "B. Etoricoxib", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B: \n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Drugs</strong></p>\n</td>\n<td>\n<p><strong>Properties </strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Indomethacin</strong></p>\n</td>\n<td>\n<ul>\n<li>Decreases<strong> </strong>Neutrophil Chemotaxis.</li>\n<li>Additional anti-inflammatory property</li>\n<li>It is used to treat osteoarthritis, <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">rheumatoid</span> <span class=\"customMeta\" data-dictid=\"6f74c7bfe0169277718240005b59d1\">arthritis</span> and Gout.</li>\n<li>It is used to close<strong> </strong>Patent <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">Ductus</span> Arteriosus.</li>\n<li><strong>Adverse effects:</strong> Severe <span class=\"customMeta\" data-dictid=\"35aa36279d16927772031c7ce8d6e5\">Frontal</span> Headache, Psychosis, Hallucinations and Suicidal tendencies.</li>\n<li><strong>Contradictions:</strong> Patients with Epilepsy, Depression, and <span class=\"customMeta\" data-dictid=\"23702653681692777196e5c0fc63cd\">Psychotic</span> problems.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Ibuprofen</strong></p>\n</td>\n<td>\n<ul>\n<li>It is used as an <span class=\"customMeta\" data-dictid=\"fe706b145216927771819c62504cd8\">Analgesic</span> in children</li>\n<li>It is used to close Patent <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">Ductus</span> Arteriosus</li>\n<li><strong>Adverse effect:</strong> <span class=\"customMeta\" data-dictid=\"50ca3536ab16927771820138ef02f8\">Aseptic</span> Meningitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Mefenamic Acid</strong></p>\n</td>\n<td>\n<ul>\n<li>It gets concentrated in the <span class=\"customMeta\" data-dictid=\"0c847ca20416927772011b3397c2fd\">uterus</span> and decreases the <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> activity</li>\n<li>It has <span class=\"customMeta\" data-dictid=\"d085fa46531692777181b8038881f2\">antipyretic</span> properties.</li>\n<li>It is used to treat dysmenorrhoea.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Paracetamol </strong></p>\n</td>\n<td>\n<ul>\n<li>It is called Acetaminophen</li>\n<li>Good <span class=\"customMeta\" data-dictid=\"fe706b145216927771819c62504cd8\">analgesic</span> and <span class=\"customMeta\" data-dictid=\"d085fa46531692777181b8038881f2\">antipyretic</span> drug (Proposed MOA is it inhibits <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">COX</span> 3 in hypothalamus)</li>\n<li>However, it is a poor anti-inflammatory drug. (The proposed theory is called <span class=\"customMeta\" data-dictid=\"7e35dc67351692777195c0be6eee0b\">peroxide</span> theory. Peroxides in the body will not allow the drug to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> COX)</li>\n<li>It is preferred in children, Bronchial asthma, safest <span class=\"customMeta\" data-dictid=\"fe706b145216927771819c62504cd8\">analgesic</span> in CKD, <span class=\"customMeta\" data-dictid=\"fe706b145216927771819c62504cd8\">analgesic</span> of choice in Osteoarthritis, safe in pregnancy and lactating mother</li>\n<li>In PCM overdose the NABQI is not metabolised by <span class=\"customMeta\" data-dictid=\"f945849e691692777188ad7ce5b5e2\">glutathione</span> leading to hepatotoxicity.</li>\n<li>N-acetyl <span class=\"customMeta\" data-dictid=\"dabfa103741692777185dac756c49b\">cysteine</span> is the <span class=\"customMeta\" data-dictid=\"5e612ce1381692777181adc76f11e6\">antidote</span> in PCM overdose. It replenishes Glutathione.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Ketorolac</strong></p>\n</td>\n<td>\n<ul>\n<li>It is given intravenously and is used for treating post-operative conditions.</li>\n<li>It is available as <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> in markets.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Nabumetone</strong></p>\n</td>\n<td>\n<ul>\n<li>It is a pro-drug used for osteoarthritis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Piroxicam</strong></p>\n</td>\n<td>\n<ul>\n<li>It is the longest-acting NSAIDS</li>\n<li>It undergoes a process called <span class=\"customMeta\" data-dictid=\"6fa49bcdd91692777187965db2303d\">Enterohepatic</span> recycling<strong>, </strong>which is why it is considered as longest acting NSAID</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Phenylbutazone</strong></p>\n</td>\n<td>\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">Marrow</span> suppression</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the subsequent options is an abortifacient, derived from synthetic PFG2 alpha?", "options": [{"label": "A", "text": "Dinoprost", "correct": false}, {"label": "B", "text": "Dinoprostone", "correct": false}, {"label": "C", "text": "Misoprostol", "correct": false}, {"label": "D", "text": "Carboprost", "correct": true}], "correct_answer": "D. Carboprost", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option d. Carboprost.\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Prostaglandin Analogue</strong></p>\n</td>\n<td>\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Dinoprost (PGF2 alpha)</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"f447020b9616927771904d1c923d80\">Induction</span> of labor</p>\n<p>- Treatment of <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p> </p>\n</td>\n<td>\n<p><strong>- Control of <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> bleeding</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Dinoprostone (PGE2)</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">Cervical</span> ripening</p>\n<p>- <span class=\"customMeta\" data-dictid=\"f447020b9616927771904d1c923d80\">Induction</span> of labor</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p> </p>\n</td>\n<td>\n<p><strong>- <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">Termination</span> of pregnancy (medical abortion)</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Misoprostol (PGE1)</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">Termination</span> of pregnancy (medical abortion)</p>\n<p>- <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">Cervical</span> ripening</p>\n<p>- Prevention and treatment of <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p> </p>\n</td>\n<td>\n<p><strong>- Prevention of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> ulcers in certain cases</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Carboprost (PGF2 alpha)</p>\n</td>\n<td>\n<p>- <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">Termination</span> of pregnancy</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td>\n<p> </p>\n</td>\n<td>\n<p><strong>- Prevention and treatment of <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Why is cisatracurium preferred over atracurium?", "options": [{"label": "A", "text": "It has rapid onset of action", "correct": false}, {"label": "B", "text": "It has less depressant action on heart", "correct": false}, {"label": "C", "text": "It has short duration of action", "correct": false}, {"label": "D", "text": "It causes less release of histamine", "correct": true}], "correct_answer": "D. It causes less release of histamine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following helps in maintaining the patency of ductus arteriosus ?", "options": [{"label": "A", "text": "PGF2α", "correct": false}, {"label": "B", "text": "PGE1", "correct": true}, {"label": "C", "text": "PGH2", "correct": false}, {"label": "D", "text": "PGI2", "correct": false}], "correct_answer": "B. PGE1", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - PGE\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Prostaglandin Analogue</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Prostaglandin E1 (PGE1)</strong></p>\n</td>\n<td>\n<p>Used to maintain the <span class=\"customMeta\" data-dictid=\"8c660f0c321692777194046901e354\">patency</span> of the <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus in specific clinical situations, such as newborns with critical <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> heart defects.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Prostaglandin F2α (PGF2α)</strong></p>\n</td>\n<td>\n<p> Has various <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> applications, such as <span class=\"customMeta\" data-dictid=\"f447020b9616927771904d1c923d80\">induction</span> of labor or treatment of glaucoma.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Prostacyclin (PGI2)</strong></p>\n</td>\n<td>\n<p> Has therapeutic applications such as treatment of <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> hypertension. Also has <span class=\"customMeta\" data-dictid=\"4665fdd0a0169277718100f58eb0d5\">anti</span> <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> effect.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "How does colchicine work in the body?", "options": [{"label": "A", "text": "Inhibits synthesis of uric acid", "correct": false}, {"label": "B", "text": "Promotes excretion of uric acid", "correct": false}, {"label": "C", "text": "Inhibits xanthine oxidase enzyme", "correct": false}, {"label": "D", "text": "Binds to tubulin and inhibits granulocyte migration", "correct": true}], "correct_answer": "D. Binds to tubulin and inhibits granulocyte migration", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Colch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the compound that prostaglandin, indicated for multiple conditions, is derived from?", "options": [{"label": "A", "text": "Stearic acid", "correct": false}, {"label": "B", "text": "Arachidonic acid", "correct": true}, {"label": "C", "text": "Linoleic acid", "correct": false}, {"label": "D", "text": "Linolenic acid", "correct": false}], "correct_answer": "B. Arachidonic acid", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is pegloticase used for ?", "options": [{"label": "A", "text": "Chronic gout", "correct": true}, {"label": "B", "text": "Rheumatoid arthritis", "correct": false}, {"label": "C", "text": "Psoriatic arthritis", "correct": false}, {"label": "D", "text": "Paralytic ileus", "correct": false}], "correct_answer": "A. Chronic gout", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<thead>\n<tr>\n<td>\n<p><strong>Drug</strong></p>\n</td>\n<td>\n<p><strong>Pegloticase</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Indication</p>\n</td>\n<td>\n<p>Chronic gout</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Mechanism of Action</p>\n</td>\n<td>\n<p>Breaks down <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid crystals and lowers <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid levels</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Administration</p>\n</td>\n<td>\n<p>Intravenous infusion</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Dosage</p>\n</td>\n<td>\n<p>Every two weeks</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Use</p>\n</td>\n<td>\n<p>Treatment of severe <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> in adult patients who have not responded well to other treatments or cannot tolerate other treatment options</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Not for use in</p>\n</td>\n<td>\n<p>Rheumatoid arthritis, psoriatic arthritis, or other forms of arthritis</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "NAPQI is the metabolite of which of the following drug toxicity?", "options": [{"label": "A", "text": "Aspirin", "correct": false}, {"label": "B", "text": "Paracetamol", "correct": true}, {"label": "C", "text": "Diclofenac", "correct": false}, {"label": "D", "text": "Ketorolac", "correct": false}], "correct_answer": "B. Paracetamol", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Methotrexate usage causes reduced synthesis of:", "options": [{"label": "A", "text": "TMP", "correct": true}, {"label": "B", "text": "CMP", "correct": false}, {"label": "C", "text": "GMP", "correct": false}, {"label": "D", "text": "AMP", "correct": false}], "correct_answer": "A. TMP", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - TMP (Thymidine Monophosphate)\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the management of Thalamic Dejerine Syndrome, which of the following drugs is the least useful?", "options": [{"label": "A", "text": "Pregabalin", "correct": false}, {"label": "B", "text": "Carbamazepine", "correct": false}, {"label": "C", "text": "Gabapentin", "correct": false}, {"label": "D", "text": "NSAID analgesic", "correct": true}], "correct_answer": "D. NSAID analgesic", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\"&gt;NSAID&lt;/span&gt; Analg\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female delivered a male baby developed PPH was treated with ergometrine but not able to stop the bleeding. Which of the following is a prostaglandin derivative that can be used in the treatment of this patient?", "options": [{"label": "A", "text": "Misoprostol", "correct": false}, {"label": "B", "text": "Dinoprost", "correct": false}, {"label": "C", "text": "Carboprost", "correct": true}, {"label": "D", "text": "Latanoprost", "correct": false}], "correct_answer": "C. Carboprost", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male with complaints of urine hesitancy and retention of urine comes to ER. On investigation, his USG shows residual urine of 130 ml. Which of the following drug is used in the treatment of this patient?", "options": [{"label": "A", "text": "Calcium channel blockers", "correct": false}, {"label": "B", "text": "5 alpha reductase inhibitors", "correct": true}, {"label": "C", "text": "ACE inhibitors", "correct": false}, {"label": "D", "text": "Aldosterone antagonist", "correct": false}], "correct_answer": "B. 5 alpha reductase inhibitors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - 5 &lt;span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\"&gt;alpha&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\"&gt;reductase&lt;/span&gt; inh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Drug contraindicated in asthma patients during the management of postpartum haemorrhage is", "options": [{"label": "A", "text": "Carboprost", "correct": true}, {"label": "B", "text": "Oxytocin", "correct": false}, {"label": "C", "text": "Dinoprostone", "correct": false}, {"label": "D", "text": "Methyl ergometrine", "correct": false}], "correct_answer": "A. Carboprost", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A physician prescribed a drug that reduces the synthesis of uric acid for the gout. Identify the drug.", "options": [{"label": "A", "text": "Probenecid", "correct": false}, {"label": "B", "text": "Colchicine", "correct": false}, {"label": "C", "text": "Diclofenac", "correct": false}, {"label": "D", "text": "Allopurinol", "correct": true}], "correct_answer": "D. Allopurinol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Allopu\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allopurinol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rash, diarrhea, nausea, liver function test abnormalities</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Febuxostat</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nausea, rash, liver function test abnormalities</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Probenecid</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uriosuric agent</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rash, <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Colchicine</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anti-inflammatory</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Diarrhea, nausea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, myopathy, <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> suppression, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> neuropathy</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following is not preferred as an analgesic in rheumatoid arthritis ?", "options": [{"label": "A", "text": "Tramadol", "correct": false}, {"label": "B", "text": "Ketorolac", "correct": true}, {"label": "C", "text": "Naproxen", "correct": false}, {"label": "D", "text": "Oxycodone", "correct": false}], "correct_answer": "B. Ketorolac", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - K\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nonsteroidal Anti-inflammatory Drugs (NSAIDs)</p>\n</td>\n<td>\n<p>Ibuprofen, Naproxen, Celecoxib</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and relieve pain</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Disease-modifying <span class=\"customMeta\" data-dictid=\"fc3fc706581692777181d901117e4a\">Antirheumatic</span> Drugs (DMARDs)</p>\n</td>\n<td>\n<p>Methotrexate, Sulfasalazine, Hydroxychloroquine</p>\n</td>\n<td>\n<p>Slow or stop&gt;</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Biologic DMARDs</p>\n</td>\n<td>\n<p>Adalimumab, Etanercept, Infliximab</p>\n</td>\n<td>\n<p>Target specific immune system components involved in inflammation</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Janus <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">Kinase</span> Inhibitors (JAK inhibitors)</p>\n</td>\n<td>\n<p>Tofacitinib, Baricitinib</p>\n</td>\n<td>\n<p>Inhibit Janus kinase, an <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> involved in immune system signaling</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Corticosteroids</p>\n</td>\n<td>\n<p>Prednisone, Methylprednisolone</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and suppress the immune system</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on aspirin presented with occult blood in the stool. This occurs due to the inhibition of ________ by aspirin.", "options": [{"label": "A", "text": "Phospholipase A2", "correct": false}, {"label": "B", "text": "Thromboxane", "correct": true}, {"label": "C", "text": "Phospholipase C", "correct": false}, {"label": "D", "text": "Phospholipase D", "correct": false}], "correct_answer": "B. Thromboxane", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Aspirin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"ebd6f6186316927771854d3b6d65be\">cyclooxygenase</span> (COX) enzymes, particularly COX-1 and COX-2. COX-1 is involved in the production of prostaglandins and<strong> thromboxane.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Effect on platelets </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Thromboxane A2 is a potent pro-inflammatory and pro-thrombotic molecule that promotes <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> <span class=\"customMeta\" data-dictid=\"a00e90be0416927771803afbbf099b\">aggregation</span> and vasoconstriction.</li>\n<li>By inhibiting COX-1, <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> reduces the production of <span class=\"customMeta\" data-dictid=\"96309dcb1c169277720072ad555473\">thromboxane</span> A2, which leads to decreased <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> <span class=\"customMeta\" data-dictid=\"a00e90be0416927771803afbbf099b\">aggregation</span> and a <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> tendency for <span class=\"customMeta\" data-dictid=\"40d68b98721692777183c42090e023\">blood clot</span> formation, which can contribute to <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> bleeding, including the presence of <span class=\"customMeta\" data-dictid=\"c8d9b6cbbb1692777194c4bc31f01f\">occult</span> blood in the stool.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Analgesic: <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">Rheumatoid</span> arthritis</li>\n<li>Antipyretic</li>\n<li>Antiplatelet: Post Myocardial <span class=\"customMeta\" data-dictid=\"657b33591e16927771902ea85cfde8\">infraction</span> and CVA</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>0.5-2 g/day - <span class=\"customMeta\" data-dictid=\"fe706b145216927771819c62504cd8\">analgesic</span> dose</strong></p>\n<ul>\n<li>Nausea and vomiting</li>\n<li>Epigastric discomfort</li>\n</ul>\n<p><strong>3-5 g/day - anti-inflammatory dose</strong></p>\n<ul>\n<li>Salicylism - vertigo, hyperventilation, tinnitus, <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> loss of hearing</li>\n<li>Hepatitis</li>\n<li>Hypersensitivity</li>\n</ul>\n<p><strong>Reye’s syndrome</strong>: A rare condition seen when salicylates are given in children suffering from <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> infections such as influenza, presenting as <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> liver failure.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Urine alkalinization will be most useful in toxicity of which of the following drugs?", "options": [{"label": "A", "text": "Beta-blockers", "correct": false}, {"label": "B", "text": "Calcium channel blockers", "correct": false}, {"label": "C", "text": "Acetaminophen", "correct": false}, {"label": "D", "text": "Aspirin", "correct": true}], "correct_answer": "D. Aspirin", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rXHAYoO6HK6VZgIAjWe71745480331.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspirin Toxicity:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Aspirin stimulates the brain's <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> center, causing <span class=\"customMeta\" data-dictid=\"e07ff4a5ce1692777189b9e95326f3\">hyperventilation</span> (↓CO2 levels) and <strong>respiratory alkalosis</strong></li>\n<li>The kidneys <span class=\"customMeta\" data-dictid=\"350d30aa5316927771874442f8874c\">excrete</span> more <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> to counteract <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> alkalosis, resulting in <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> <span class=\"customMeta\" data-dictid=\"6caf3a39f416927771807e122b9032\">acidosis</span> <strong>(Compensatory <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis).</strong> High doses of <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> can disrupt <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> <span class=\"customMeta\" data-dictid=\"619ba5e99c16927771958308fb8687\">phosphorylation</span> and <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> function, exacerbating <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dosage and Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Therapeutic Dose: 3-5 g/day can cause <strong>mild chronic <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> (salicylism)</strong></li>\n<li>Toxic Dose: Acute <span class=\"customMeta\" data-dictid=\"eba893313f16927771906290ce7e79\">ingestion</span> of 10-30 g in adults can be lethal, with much lower doses (4 mL of <span class=\"customMeta\" data-dictid=\"bc09155adc169277719248f9543785\">methyl</span> salicylate) posing a significant risk in children</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Salicylism</strong>: Headache, dizziness, tinnitus, <strong>reversible hearing and vision impairment,</strong> drowsiness, vomiting, hyperventilation, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> imbalance</li>\n<li>Severe toxicity: Dehydration, <strong>high tone deafness</strong>, confusion, petechial haemorrhages, <strong>hyperpyrexia</strong><strong>, </strong><strong>seizures, hypoglycemia, </strong>psychosis, coma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment is supportive and includes <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> lavage, <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> of <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis, vitamin K supplements and<strong> <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"91f580d150169277718171ee6ba559\">alkalinization</span> with <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> sodium bicarbonate</strong> to enhance <span class=\"customMeta\" data-dictid=\"ac91ef7dac16927771985192826d28\">salicylate</span> excretion. In severe cases, <span class=\"customMeta\" data-dictid=\"6ba3fb0ce51692777188eaf7843351\">hemodialysis</span> may be necessary.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What medication is administered to prevent chemotherapy-induced nausea and vomiting in a 45-year-old woman with lung adenocarcinoma who has experienced these symptoms during her previous treatment visits?", "options": [{"label": "A", "text": "Metoclopramide", "correct": false}, {"label": "B", "text": "Ropinirole", "correct": false}, {"label": "C", "text": "Domperidone", "correct": false}, {"label": "D", "text": "Palonosetron", "correct": true}], "correct_answer": "D. Palonosetron", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Palonosetron</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>5HT-3 Antagonists (Anti-motility drugs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>5HT-4 Agonists (Prokinetic drugs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Block 5HT-3 receptors</strong> in the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> and central nervous system.</li>\n<li><strong>Decrease</strong> <span class=\"customMeta\" data-dictid=\"6043ec42cf169277719044e8ee3234\">intestinal motility</span> and secretion.</li>\n<li>Inhibit the <span class=\"customMeta\" data-dictid=\"64f968d2251692777184286bce1af6\">chemoreceptor</span> trigger zone (CTZ) in the area postrema, reducing <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Activate 5HT-4 receptors</strong> in the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> tract.</li>\n<li><strong>Increase</strong> <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">motility</span> and secretion.</li>\n<li>Enhances the release of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> from <span class=\"customMeta\" data-dictid=\"85c304623c1692777187da4d1f1ee7\">enteric</span> neurons.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ondansetron</li>\n<li>Granisetron</li>\n<li>Dolasetron</li>\n<li><strong>Palonosetron</strong></li>\n<li>Alosetron</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metoclopramide</li>\n<li>Cisapride (withdrawn due to QT prolongation)</li>\n<li>Tegaserod (restricted use due to <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> risks)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV)</strong></li>\n<li>Postoperative <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV)</li>\n<li>Radiation-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (RINV)</li>\n<li>Irritable <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome with diarrhoea (IBS-D): Alosetron</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Gastroparesis</li>\n<li>Gastroesophageal <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> disease (GERD)</li>\n<li>Functional dyspepsia</li>\n<li>Chronic constipation</li>\n<li>Postoperative ileus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Headache</li>\n<li>Constipation</li>\n<li>Dizziness</li>\n<li>Fatigue</li>\n<li>Prolonged QT interval (rare)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Diarrhea</li>\n<li>Abdominal pain</li>\n<li>Nausea</li>\n<li>Headache</li>\n<li>Prolonged QT interval (Cisapride, Tegaserod)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male presents with diffuse abdominal pain. He has a known history of chronic NSAID usage. Physical examination reveals rigidity. An X-ray of the abdomen is shown below. What is the diagnosis?", "options": [{"label": "A", "text": "Intestinal obstruction", "correct": false}, {"label": "B", "text": "Pericarditis", "correct": false}, {"label": "C", "text": "Peptic ulcer perforation", "correct": true}, {"label": "D", "text": "Gallstones", "correct": false}], "correct_answer": "C. Peptic ulcer perforation", "question_images": ["https://image.prepladder.com/notes/HuvHNcUjaTfVYL0C7UGt1747899878.png"], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"f6768ff15f1692777195a493cad3a9\"&gt;Peptic&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\"&gt;ulcer&lt;/span&gt; perforation</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects of NSAIDs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Additional information</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gastrointestinal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nausea and vomiting</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Selective COX-2 inhibitors:</strong> Less likely to cause GI side effects</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>GI hemorrhage, erosion, <strong>Ulcers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Due to ↓prostaglandin synthesis, leading to loss of mucosal protection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hematological</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Platelet <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> → Increased bruising and <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> risk</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>From <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"96309dcb1c169277720072ad555473\">thromboxane</span> A2 activity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Renal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Renal dysfunction/failure</li>\n<li>Reduction in <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> of <span class=\"customMeta\" data-dictid=\"1848b160c11692777191b60caaf622\">loop diuretics</span> &amp; antihypertensives</li>\n<li>Salt and water retention</li>\n<li><strong>Hyperkalemia </strong></li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> necrosis</li>\n<li>Renal <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> necrosis</li>\n<li>Interstitial nephritis</li>\n<li>Analgesic nephropathy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Analgesic nephropathy</strong> leads to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure with <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and chronic <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> nephritis, which is less common since the ban of <strong>phenacetin.</strong></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cardiovascular</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Precipitate heart failure</li>\n<li>Edema</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hepatic</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Elevated liver enzymes</li>\n<li>Hepatic failure</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypersensitivity</strong></p>\n<p> </p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Urticaria</li>\n<li>Flushing</li>\n<li>Anaphylaxis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dermatological</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Steven-Johnson syndrome</li>\n<li>Photosensitivity</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with acute swelling in the big toe, and his serum uric acid levels were increased. The doctor prescribed medicine to manage this acute condition. What is the mechanism of this drug?", "options": [{"label": "A", "text": "Pyrimidine antimetabolite", "correct": false}, {"label": "B", "text": "Uricosuric drug", "correct": false}, {"label": "C", "text": "Xanthine oxidase inhibitor", "correct": false}, {"label": "D", "text": "Neutrophil chemotaxis prevention", "correct": true}], "correct_answer": "D. Neutrophil chemotaxis prevention", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\"&gt;Neutrophil&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"131fe589f71692777184dc879b32db\"&gt;chemotaxis&lt;/span&gt; prevention</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attack of gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>DOC- NSAIDS (All types) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Except for <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and paracetamol</li>\n<li>Anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Colchicine (spindle poison)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>MOA: <span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\">Microtubule</span> inhibitor</strong></li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attacks of <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> and <span class=\"customMeta\" data-dictid=\"5dda3cc2ab1692777202b3b3c65bea\">familial</span> Mediterranean fever and is also the <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for karyotyping</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intra <span class=\"customMeta\" data-dictid=\"cd001152fe16927771823275439a2d\">articular</span> injections, avoid oral route</li>\n<li>Immunosuppressive and anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for chronic gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitors (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include<strong> <span class=\"customMeta\" data-dictid=\"6337926de316927771812a6842721f\">Allopurinol</span> (DOC)</strong>, Oxipurinol, <strong>Febuxostat</strong></li>\n<li><strong>MOA: Blocks <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> → Inhibits the conversion of <span class=\"customMeta\" data-dictid=\"304c30e55316927771895062b17e8b\">hypoxanthine</span> to <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid in the liver.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uric acid <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> enzyme</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include <strong>Pegloticase </strong>and Rasburicase</li>\n<li><strong>MOA: <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid is converted to <span class=\"customMeta\" data-dictid=\"eae976dfa31692777181804c2b20e7\">allantoin</span> and excreted in urine</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uricosuric agents (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include Probenecid, Benzbromaron, Sulfinpyrazone, <strong>Lesinurad</strong></li>\n<li><strong>MOA:</strong> <strong>Inhibit OATP transporter/URAT-1 in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> → inhibits <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid → increased <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid.</strong></li>\n</ul>\n<p> </p>\n<p>(OATP - Organic <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> transport protein, URAT-1 - <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid transporter)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is used in the closure of patent ductus arteriosus?", "options": [{"label": "A", "text": "Magnesium sulfate", "correct": false}, {"label": "B", "text": "Alprostadil", "correct": false}, {"label": "C", "text": "Indomethacin", "correct": true}, {"label": "D", "text": "Paracetamol", "correct": false}], "correct_answer": "C. Indomethacin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Indomethacin</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<thead>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses of NSAIDs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>NSAIDs are avoided in</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Analgesic (in all types of pain except neuropathic pain)</li>\n<li>Antipyretic</li>\n<li>Anti-inflammatory</li>\n<li>Antiplatelet</li>\n<li>Tocolytic</li>\n<li><strong>Closure of PDA</strong></li>\n</ul>\n</td>\n<td rowspan=\"6\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pregnancy (as it causes <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">premature</span> <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> of <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus)</li>\n<li>Inflammatory <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> disease (IBD)</li>\n<li>Safest <span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\">NSAID</span> in these cases is <strong>paracetamol.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</thead>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A student complains of developing urticaria following the consumption of seafood. Considering the need for non-sedating medication due to an upcoming exam, which of the following drugs would you choose to prescribe?", "options": [{"label": "A", "text": "Chlorpheniramine", "correct": false}, {"label": "B", "text": "Diphenhydramine", "correct": false}, {"label": "C", "text": "Hydroxyzine", "correct": false}, {"label": "D", "text": "Fexofenadine", "correct": true}], "correct_answer": "D. Fexofenadine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Fexofenadine</p>\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Generalised Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>1st Generation</strong></p>\n<p style=\"text-align: center;\"> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diphenhydramine </strong>(<strong>Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sedation, drowsiness, dry mouth, blurred vision</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergy symptoms, Insomnia, Motion sickness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Chlorpheniramine </strong>(<strong>Option A)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sedation, drowsiness, dry mouth</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergy symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hydroxyzine </strong>(<strong>Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anxiety, <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">Allergy</span> symptoms, Pruritus</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>2nd Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Loratadine </strong></p>\n<p> </p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Minimal sedation, dry mouth</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergy symptoms, Urticaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cetirizine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergy symptoms, Itchiness, Urticaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fexofenadine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Non-sedating, minimal side effects</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergy symptoms, Chronic <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> urticaria</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An HIV-positive woman on ART was prescribed ergotamine for a migraine attack four days ago. She presented with complaints that she has been unable to feel her legs, from the mid-thigh to her toes, for the past two days. The angiographic image is given below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Atherosclerosis", "correct": false}, {"label": "B", "text": "Ergotism", "correct": true}, {"label": "C", "text": "Polyradicular neuropathy", "correct": false}, {"label": "D", "text": "Herniated disc", "correct": false}], "correct_answer": "B. Ergotism", "question_images": ["https://image.prepladder.com/notes/c7vq5OB0DLtPRZJa2wfw1747048948.png"], "explanation_images": [], "explanation": "<p>Correct Answer B - Erg\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A pregnant woman was prescribed indomethacin. Which of the following effects will the drug have on the fetus?", "options": [{"label": "A", "text": "Premature closure of ductus arteriosus", "correct": true}, {"label": "B", "text": "Keeps ductus arteriosus patent", "correct": false}, {"label": "C", "text": "Closure of fossa ovalis", "correct": false}, {"label": "D", "text": "Premature closure of ductus venosus", "correct": false}], "correct_answer": "A. Premature closure of ductus arteriosus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with swelling in his big toe , and his serum uric acid levels were found to be elevated. After acute treatment, the patient was put on a maintenance regimen with a drug which is considered first-line management for chronic gout; What is the mechanism of action of this drug?", "options": [{"label": "A", "text": "Pyrimidine antimetabolite", "correct": false}, {"label": "B", "text": "Inhibitor of neutrophil recruitment", "correct": false}, {"label": "C", "text": "Uricosuric drug", "correct": false}, {"label": "D", "text": "Xanthine oxidase inhibitor", "correct": true}], "correct_answer": "D. Xanthine oxidase inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Xanthine &lt;span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\"&gt;oxidase&lt;/span&gt; inh\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">Oxidase</span> Inhibitors</p>\n</td>\n<td>\n<p>Allopurinol, Febuxostat</p>\n</td>\n<td>\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> oxidase, the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> involved in <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid production</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Uricosuric Agents</p>\n</td>\n<td>\n<p>Probenecid, Lesinurad</p>\n</td>\n<td>\n<p>Increase <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> from the kidneys</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Colchicine</p>\n</td>\n<td>\n<p>Colchicine</p>\n</td>\n<td>\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and reduce <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> attacks</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nonsteroidal Anti-inflammatory Drugs (NSAIDs)</p>\n</td>\n<td>\n<p>Ibuprofen, Naproxen</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and relieve pain</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Glucocorticoids</p>\n</td>\n<td>\n<p>Prednisone, Methylprednisolone</p>\n</td>\n<td>\n<p>Reduce <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and relieve pain</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 56-year-old male comes to the outpatient department for a routine health check-up. The patient is obese and has smoked for 30 years . His past medical history includes hypertension for 10 years and diabetes mellitus for 8 years , for which he takes amlodipine and metformin pills regularly. On examination, his blood pressure is 140/90 mmHg , and lab findings reveal a cholesterol level of 170 mg/dL. The physician prescribes aspirin to prevent ischemic heart disease . This drug prevents ischemic heart disease by which of the following mechanism of action?", "options": [{"label": "A", "text": "Inhibiting TXA2 synthesis by platelets", "correct": true}, {"label": "B", "text": "Inhibiting prostacyclin synthesis", "correct": false}, {"label": "C", "text": "Inhibiting the release of EDRF", "correct": false}, {"label": "D", "text": "Inhibiting the synthesis of endothelins", "correct": false}], "correct_answer": "A. Inhibiting TXA2 synthesis by platelets", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Inhibiting TXA2 &lt;span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\"&gt;synthesis&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 48 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old man presents with complaints of recurrent episodes of sudden jerking movements involving his arms and legs. He has no other medical conditions and has been prescribed an antiepileptic drug. Which of the following medications acts by blocking sodium channels?", "options": [{"label": "A", "text": "Tiagabine", "correct": false}, {"label": "B", "text": "Levetiracetam", "correct": false}, {"label": "C", "text": "Phenytoin", "correct": true}, {"label": "D", "text": "Phenobarbitone", "correct": false}], "correct_answer": "C. Phenytoin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/koh0jpCFALDN2Yoc7ziN1736829221.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:715px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sodium channel blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><strong>Potassium Channel openers</strong></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcium channel blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibit <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> release</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facilitate GABA-mediated Cl-channel opening</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Phenytoin</li>\n<li>Carbamazepine</li>\n<li>Valproate</li>\n<li>Topiramate</li>\n<li>Lamotrigine</li>\n<li>Lacosamide</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Retigabine</li>\n<li>Ezogabine</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Valproate</li>\n<li>Ethosuximide</li>\n<li>Zonisamide (2nd line)</li>\n<li>Levetiracetam (2nd line)</li>\n<li>Clonazepam (2nd line)</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Phenobarbitone</li>\n<li>Phenytoin</li>\n<li>Lamotrigine</li>\n<li>Topiramate</li>\n<li>Valproate</li>\n<li>Levetiracetam</li>\n<li>Lacosamide</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Barbiturate</li>\n<li>Benzodiazepine</li>\n<li>Vigabatrin</li>\n<li>Valproate</li>\n<li>Gabapentin</li>\n<li>Tiagabine<strong> </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LfZYOynSWr8QSzoxchwQ1749049334.mp3", "video": ""}, {"text": "A 10-year-old child is brought by his parents due to episodes of brief staring spells associated with a loss of awareness, lasting 10 to 20 seconds, occurring multiple times a day, especially during stress or fatigue. Which of the following is the drug of choice for this condition?", "options": [{"label": "A", "text": "Valproate", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Ethosuximide", "correct": true}], "correct_answer": "D. Ethosuximide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KKbwm9tv6wZoUarzfNx71745662625.mp3", "video": ""}, {"text": "A 12-year-old with Lennox-Gastaut syndrome is on valproate for seizure control. During a follow-up, the neurologist reviews valproate's uses and potential side effects. Which of the following is NOT true regarding valproate?", "options": [{"label": "A", "text": "Used in the treatment of Dravet syndrome", "correct": false}, {"label": "B", "text": "Drug of choice in atypical absence seizures", "correct": false}, {"label": "C", "text": "Used in the treatment of mania", "correct": false}, {"label": "D", "text": "Causes purple glove syndrome", "correct": true}], "correct_answer": "D. Causes purple glove syndrome", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lennox-Gastaut syndrome</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Approved and effective</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dravet syndrome</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used, especially if other options like stiripentol are limited</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atypical absence seizures</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug of choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bipolar disorder (mania)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used as mood stabilizer</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:556px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Notable Points</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatotoxicity (especially in &lt;2 y/o)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Black box warning</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare but serious</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Teratogenicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neural tube defects</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperammonemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May cause encephalopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NOT associated with Purple Glove</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This is <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to <strong>IV phenytoin</strong>, not valproate</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GdE417mktKP3kL9RkEWO1749049458.mp3", "video": ""}, {"text": "Which of the following is not a potential adverse effect of Phenytoin?", "options": [{"label": "A", "text": "Generalised lymphadenopathy", "correct": false}, {"label": "B", "text": "Osteomalacia", "correct": false}, {"label": "C", "text": "Megaloblastic anemia", "correct": false}, {"label": "D", "text": "Weight Loss", "correct": true}], "correct_answer": "D. Weight Loss", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IT0BlRPj9m1VIdCElP4h1749049548.mp3", "video": ""}, {"text": "A 6-month-old infant is brought up due to concerns about episodes of sudden, repetitive muscle contractions involving his arms and legs. An EEG reveals a hypsarrhythmia pattern. Genetic testing reveals a mutation in the TSC1 gene. Which of the following is the drug of choice in this condition?", "options": [{"label": "A", "text": "Clonazepam", "correct": false}, {"label": "B", "text": "Valproate", "correct": false}, {"label": "C", "text": "Vigabatrin", "correct": true}, {"label": "D", "text": "Ethosuximide", "correct": false}], "correct_answer": "C. Vigabatrin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QtmzaeIXyPerBLuanuSl1749049656.mp3", "video": ""}, {"text": "A 60-year-old woman presents with severe, sharp, electric shock-like pain on the right side of her face. The pain, triggered by talking, chewing, and touching her face, lasts a few seconds to minutes and has become increasingly frequent and debilitating. Which of the following medications is the drug of choice for treating her condition?", "options": [{"label": "A", "text": "Carbamazepine", "correct": true}, {"label": "B", "text": "Gabapentin", "correct": false}, {"label": "C", "text": "Diazepam", "correct": false}, {"label": "D", "text": "Levetiracetam", "correct": false}], "correct_answer": "A. Carbamazepine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:712px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbamazepine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits high-frequency neuronal discharges and modulates voltage-gated sodium channels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trigeminal neuralgia, GTCS, partial seizures, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, dizziness, ataxia, GI disturbances, <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> suppression, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions, water retention.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gabapentin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enhances GABA release modulates voltage-sensitive Ca2+ channels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partial seizures, post-herpetic neuralgia, <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> prophylaxis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, tiredness, dizziness, tremor, unsteadiness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diazepam</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enhances GABAergic neurotransmission.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Status epilepticus, Febrile seizure.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thrombophlebitis, hypotension, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Topiramate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple mechanisms, including <span class=\"customMeta\" data-dictid=\"276be2047116927771989f7bf5ed02\">sodium channel</span> inactivation, GABA potentiation, <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism, and <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> channel modulation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GTCS, myoclonic epilepsy, and absence of seizures.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Impairment of attention, sedation, ataxia, word-finding difficulties, poor memory, weight loss, paresthesias, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> stones.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nyR4WJDlMGG0LB0bNO3M1749049748.mp3", "video": ""}, {"text": "Which of the following adverse effects is associated with carbamazepine use?", "options": [{"label": "A", "text": "Hypoglycemia", "correct": false}, {"label": "B", "text": "Hypertension", "correct": false}, {"label": "C", "text": "Weight gain", "correct": false}, {"label": "D", "text": "Agranulocytosis", "correct": true}], "correct_answer": "D. Agranulocytosis", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neurotoxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, dizziness, vertigo, diplopia, and ataxia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gastrointestinal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vomiting and diarrhoea occur with higher doses.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute Intoxication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coma, convulsions, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> collapse.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Haematological</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Agranulocytosis, <span class=\"customMeta\" data-dictid=\"1ea06afcbd1692777181199bfa3300\">aplastic</span> anaemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypersensitivity Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rashes, photosensitivity, hepatitis, lupus-like syndrome.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Water <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">Retention</span> and Hyponatremia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to enhanced <span class=\"customMeta\" data-dictid=\"27bd08bbaa16927771812e98e16787\">antidiuretic</span> hormone (ADH) action, it is more common in the elderly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Teratogenicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"17cd3771bb1692777190950c142dbe\">incidence</span> of minor <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> malformations.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Gy79iPxq6ULpJzeDq1Zh1749049838.mp3", "video": ""}, {"text": "A 28-year-old pregnant woman with a history of epilepsy presents for a prenatal visit. She is currently taking medication to control her seizures and is concerned about the safety of her medication during pregnancy. Which of the following drugs is considered the drug of choice for managing her condition?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Lamotrigine", "correct": false}, {"label": "C", "text": "Gabapentin", "correct": false}, {"label": "D", "text": "Levetiracetam", "correct": true}], "correct_answer": "D. Levetiracetam", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Levetiracetam binds to <span class=\"customMeta\" data-dictid=\"5c4592475a1692777199991c761d11\">synaptic</span> <span class=\"customMeta\" data-dictid=\"4b0fee14c816927772016e67cf3a13\">vesicular</span> protein SV2A, modulating <span class=\"customMeta\" data-dictid=\"e28fd027b416927771932bc23ba0a5\">neurotransmitter</span> release (e.g., glutamate, GABA) and inhibiting N-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is used for the management of partial seizures and myoclonic epilepsy.</li>\n<li>It is also utilised as adjunctive therapy for <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> partial seizures.</li>\n<li>Additionally, it serves as second-line adjunctive therapy for generalised <span class=\"customMeta\" data-dictid=\"a4156d43e216927772008460f9b582\">tonic-clonic</span> seizures and absence seizures, although it is not approved for children below 4 years.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sleepiness, dizziness, weakness, behavioural changes (rare) and potential driving impairment.</li>\n<li>It is generally well-tolerated and is not metabolised by CYP enzymes, resulting in minimal drug interactions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8wMruJ4zptL0LHyuAfor1749049937.mp3", "video": ""}, {"text": "A 28-year-old male with a history of epilepsy presents to the emergency department with ongoing tonic-clonic seizures that have lasted for the past 20 minutes. What is the initial drug of choice for the management of status epilepticus in this clinical scenario?", "options": [{"label": "A", "text": "Phenobarbital", "correct": false}, {"label": "B", "text": "Lorazepam", "correct": true}, {"label": "C", "text": "Lamotrigine", "correct": false}, {"label": "D", "text": "Valproate", "correct": false}], "correct_answer": "B. Lorazepam", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Management of status epilepticus:</u></strong></p>\n\t\t\t \n\n\t\t\t<p style=\"text-align:center\">Position the head, provide oxygen, and monitor vital signs.</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Establish <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> access and check <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> levels.</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Administer benzodiazepines (preferably <span class=\"customMeta\" data-dictid=\"4398b2978c16927771915937fed503\">lorazepam</span> IV).</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">If seizures persist after 2 doses of benzodiazepines.</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Administer <span class=\"customMeta\" data-dictid=\"0c90c7eff016927771810bd4259ad6\">antiepileptic</span> drugs (Fosphenytoin, Phenytoin, Levetiracetam, Valproic acid).</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">If <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> <span class=\"customMeta\" data-dictid=\"0d87b2adc5169277719906fa786266\">status epilepticus</span> suspected</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Initiate continuous <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> of Midazolam, Pentobarbital, Thiopental, or Propofol.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wFWwIiF5OZYFbSBIXRMl1748073375.mp3", "video": ""}, {"text": "What is the recommended therapeutic range for phenytoin?", "options": [{"label": "A", "text": "4 to 12 mcg/ml", "correct": false}, {"label": "B", "text": "5 to 40 mcg/ml", "correct": false}, {"label": "C", "text": "10 to 20 mcg/ml", "correct": true}, {"label": "D", "text": "50 to 100 mcg/ml", "correct": false}], "correct_answer": "C. 10 to 20 mcg/ml", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:394px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Therapeutic Range</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenytoin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10 to 20 mcg/ml</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Valproate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>40 to 100 mcg/ml</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenobarbitone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10 to 30 mcg/ml</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carbamazepine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5 to 10 mcg/ml</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BovjsuzjVkuZzC0uIP4k1749050056.mp3", "video": ""}, {"text": "A 28-year-old woman with epilepsy and obesity presents for a follow-up visit. She has been experiencing increased seizure frequency and is concerned about her weight. Which anti-epileptic drug is most likely to cause weight loss and potentially benefit this patient?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Gabapentin", "correct": false}, {"label": "C", "text": "Topiramate", "correct": true}, {"label": "D", "text": "Phenytoin", "correct": false}], "correct_answer": "C. Topiramate", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:651px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Topiramate (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zonisamide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acts through various mechanisms, including enhancing GABA-mediated <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> and inhibiting sodium/calcium channels and carbonic anhydrase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>FDA-approved for partial-onset seizures, generalised <span class=\"customMeta\" data-dictid=\"a4156d43e216927772008460f9b582\">tonic-clonic</span> seizures, Lennox-Gastaut syndrome, and <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> prophylaxis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>FDA-approved for adjunctive treatment of partial-onset seizures in adults.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weight Loss</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Associated with significant weight loss due to <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of <span class=\"customMeta\" data-dictid=\"d4a253810c1692777181f708ba3dc6\">appetite</span> and increased energy expenditure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-Obesity Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Combination with <span class=\"customMeta\" data-dictid=\"209dbbc4351692777195121888ef13\">phentermine</span> (Qsymia) is FDA-approved for chronic weight management in adults with <span class=\"customMeta\" data-dictid=\"765e9149d01692777183c3989c6590\">BMI</span> ≥30 or ≥27 with a weight-related comorbidity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is investigated as a potential anti-obesity medication but is not currently FDA-approved for this indication.</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weight gain</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weight loss</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weight neutral</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Valproic acid</li>\n<li>Carbamazepine</li>\n<li>Gabapentin</li>\n<li>Pregabalin</li>\n<li>Vigabatrin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topiramate</li>\n<li>Zonisamide</li>\n<li>Felbamate</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Phenytoin</li>\n<li>Lamotrigine</li>\n<li>Levetiracetam</li>\n<li>Lacosamide</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xygvVXCqicGSTIBxK8Gc1749050156.mp3", "video": ""}, {"text": "A 6-year-old boy with infantile spasms has been treated for 6 months, showing improved seizure control. The neurologist is concerned about the potential for permanent peripheral visual field defects with long-term use of his current medication. Which antiepileptic drug is most likely to cause these visual field defects, requiring regular ophthalmologic monitoring?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Valproic acid", "correct": false}, {"label": "C", "text": "Vigabatrin", "correct": true}, {"label": "D", "text": "Levetiracetam", "correct": false}], "correct_answer": "C. Vigabatrin", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ophthalmic side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vigabatrin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Significant risk of <strong>permanent <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> defects (visual field constriction) and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> toxicity.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Topiramate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potential for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> myopia, <strong>secondary angle-closure glaucoma</strong>, and visual disturbances such as blurred vision and diplopia </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1rk8RTNKGmP9i6IML75f1749050266.mp3", "video": ""}, {"text": "A 35-year-old woman with a history of anxiety and panic attacks seeks treatment for increased symptoms affecting her daily life. The physician considers prescribing a medication acting on GABA channels. Which medication would be most appropriate?", "options": [{"label": "A", "text": "Zolpidem", "correct": false}, {"label": "B", "text": "Gabapentin", "correct": false}, {"label": "C", "text": "Alprazolam", "correct": true}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "C. Alprazolam", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:690px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alprazolam (Benzodiazepine)(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Positive allosteric <span class=\"customMeta\" data-dictid=\"a4dd3586e816927771927d01e3fe29\">modulator</span> of GABA-A receptors.</li>\n<li>Enhances the effect of GABA, leading to increased <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> neurotransmission.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Generalised anxiety disorder.</li>\n<li>Panic disorder.</li>\n<li>Short-term treatment of anxiety symptoms.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zolpidem (Z-drug)(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Positive allosteric <span class=\"customMeta\" data-dictid=\"a4dd3586e816927771927d01e3fe29\">modulator</span> of GABA-A receptors, with <span class=\"customMeta\" data-dictid=\"f224b5200c16927771980b12f94a4d\">selectivity</span> for α1 subunit-containing receptors</li>\n<li>Enhances the effect of GABA, promoting sleep.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short-term treatment of insomnia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gabapentin (Gabapentinoid)(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The exact mechanism is unclear, but it is believed to involve the <span class=\"customMeta\" data-dictid=\"6c0c4e41b31692777192be0fbfce62\">modulation</span> of voltage-gated <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels and <span class=\"customMeta\" data-dictid=\"2f73e160ba1692777190d65065c95b\">indirect</span> <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> of <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Postherpetic neuralgia.</li>\n<li>Neuropathic pain.</li>\n<li>Adjunctive therapy for partial seizures.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Topiramate (Antiepileptic)(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Multiple mechanisms, including <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">enhancement</span> of <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> activity and <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> activity.</li>\n<li>It also acts on voltage-gated sodium and <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels and inhibits carbonic anhydrase.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epilepsy (partial and generalised seizures).</li>\n<li>Migraine prophylaxis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xU1ofRqc5Jh2t2zK97sP1747297084.mp3", "video": ""}, {"text": "A 28-year-old man with a history of alcohol use disorder has been abstinent for the past 2 weeks. He now reports experiencing alcohol cravings, anxiety, and difficulty sleeping. His physician considers prescribing a medication that acts on the glutamate system to help maintain abstinence and reduce the risk of relapse. Which medication would be most appropriate for this patient's condition?", "options": [{"label": "A", "text": "Memantine", "correct": false}, {"label": "B", "text": "Riluzole", "correct": false}, {"label": "C", "text": "Acamprosate", "correct": true}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "C. Acamprosate", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acamprosate </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Modulates <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> transmission, likely by acting as an <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> at <span class=\"customMeta\" data-dictid=\"000b76a37716927771932ba41c5089\">NMDA</span> receptors and an <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> at GABAA receptors</li>\n<li>It helps restore the balance between <span class=\"customMeta\" data-dictid=\"082e153b9316927771872bec02a55d\">excitatory</span> and <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> <span class=\"customMeta\" data-dictid=\"66748a30e91692777193358c35b2b0\">neurotransmission</span> disrupted by chronic alcohol use.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Maintenance of <span class=\"customMeta\" data-dictid=\"16c49a59351692777180cc3782e71d\">abstinence</span> in alcohol dependence.</li>\n<li>Reduction of alcohol craving and <span class=\"customMeta\" data-dictid=\"b4b361c37616927771979541177070\">relapse</span> risk.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Memantine</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Non-competitive <span class=\"customMeta\" data-dictid=\"000b76a37716927771932ba41c5089\">NMDA</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist.</li>\n<li>Blocks the effects of excessive <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> activity.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate to severe Alzheimer's disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Riluzole</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Glutamate release inhibitor.</li>\n<li>Blocks voltage-gated sodium channels and reduces <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> release.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amyotrophic <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> (ALS)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lgbaITbfjm4TvrzQpZSB1749050394.mp3", "video": ""}, {"text": "A 12-year-old girl with treatment-resistant epilepsy has tried multiple antiepileptic drugs without adequate seizure control. Her parents are interested in exploring alternative treatment options, including cannabidiol (CBD). Which of the following statements about CBD is most accurate?", "options": [{"label": "A", "text": "CBD is a psychoactive compound that can cause intoxication and impairment.", "correct": false}, {"label": "B", "text": "CBD has been FDA-approved for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.", "correct": true}, {"label": "C", "text": "CBD is primarily used for the treatment of chronic pain and inflammation.", "correct": false}, {"label": "D", "text": "CBD has no known drug interactions and can be safely used with all other medications.", "correct": false}], "correct_answer": "B. CBD has been FDA-approved for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YDyQt7Uu0cuwg8SHGmJ71749050527.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 35-year-old woman presents with persistent low mood, loss of interest, fatigue, difficulty concentrating, feelings of worthlessness, and occasional thoughts of self-harm for the past six months. She has a family history of depression. Diagnosed with major depressive disorder (MDD), she is started on paroxetine. Which class of drug does paroxetine fall under?", "options": [{"label": "A", "text": "Selective serotonin reuptake inhibitor", "correct": true}, {"label": "B", "text": "Serotonin and norepinephrine reuptake inhibitor", "correct": false}, {"label": "C", "text": "Tricyclic antidepressant", "correct": false}, {"label": "D", "text": "Atypical antidepressant", "correct": false}], "correct_answer": "A. Selective serotonin reuptake inhibitor", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ta38444j2Plu6RVY1I7N1736848494.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/V4EHb3ujn2qtcSw9zd7Q1749050667.mp3", "video": ""}, {"text": "A 28-year-old man presents with excessive worry, restlessness, difficulty concentrating, muscle tension, and disturbed sleep for several months. He also experiences occasional panic attacks with palpitations, sweating, and a sense of impending doom. With a family history of anxiety disorders, he is diagnosed with Generalised anxiety disorder (GAD). Which of the following medications is most appropriate for initial treatment?", "options": [{"label": "A", "text": "Selective serotonin reuptake inhibitor (SSRI)", "correct": true}, {"label": "B", "text": "Benzodiazepine", "correct": false}, {"label": "C", "text": "Serotonin and norepinephrine reuptake inhibitor (SNRI)", "correct": false}, {"label": "D", "text": "Tricyclic antidepressant (TCA)", "correct": false}], "correct_answer": "A. Selective serotonin reuptake inhibitor (SSRI)", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NW9LjwvVW5dyQvzmtQ9U1747297487.mp3", "video": ""}, {"text": "Which of the following is not true for SSRIs?", "options": [{"label": "A", "text": "Paroxetine is not safe in pregnancy", "correct": false}, {"label": "B", "text": "Sertraline is safe to use with warfarin", "correct": false}, {"label": "C", "text": "Fluoxetine is the shortest-acting SSRI", "correct": true}, {"label": "D", "text": "Escitalopram is preferred in those with heart disease", "correct": false}], "correct_answer": "C. Fluoxetine is the shortest-acting SSRI", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kN2zk6GaSoshqX0rgQLa1749050807.mp3", "video": ""}, {"text": "A 45-year-old woman presents with widespread musculoskeletal pain, fatigue, and sleep disturbances for the past six months. She describes the pain as dull and achy, affecting various areas like the neck, shoulders, back, and hips, with heightened sensitivity at tender points. After ruling out other conditions, she is diagnosed with fibromyalgia. Which medication is most appropriate for initial treatment?", "options": [{"label": "A", "text": "Venlafaxine", "correct": false}, {"label": "B", "text": "Duloxetine", "correct": true}, {"label": "C", "text": "Vilazodone", "correct": false}, {"label": "D", "text": "Vortioxetine", "correct": false}], "correct_answer": "B. Duloxetine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibromyalgia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A chronic condition characterized by widespread <span class=\"customMeta\" data-dictid=\"09b955b4f91692777193bd4080e7fc\">musculoskeletal</span> pain, fatigue, sleep disturbances, and cognitive <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> (often <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as \"fibro fog\").</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The exact cause is unknown, but it is thought to involve central sensitization, where the brain processes pain signals abnormally.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Widespread pain in areas like the neck, shoulders, back, hips.</p>\n<p>Fatigue, sleep disturbances, and cognitive <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (fibro fog).</p>\n<p>Tenderness at specific points on the body.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily clinical, based on symptoms and the <span class=\"customMeta\" data-dictid=\"1cc6e4677116927771870a10c66fe7\">exclusion</span> of other conditions. There is no <span class=\"customMeta\" data-dictid=\"32b854324a1692777185c6c79fdc99\">definitive</span> laboratory test for fibromyalgia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pharmacologic treatment includes medications like SSRIs (Selective <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">Serotonin</span> <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">Reuptake</span> Inhibitors), SNRIs (Serotonin-Norepinephrine <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">Reuptake</span> Inhibitors), and anticonvulsants like pregabalin. Non-pharmacologic approaches include physical therapy, exercise, and cognitive-behavioral therapy.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XYKWtmuoR7t3mFRgF3ZE1749050965.mp3", "video": ""}, {"text": "A 9-year-old child presents with a history of involuntary bedwetting during sleep at least twice a week for the past 6 months. Physical examination and laboratory investigations reveal no abnormalities. The child has no daytime urinary symptoms or signs of urinary tract infection. After ruling out organic causes, what is the most appropriate pharmacological treatment for this condition?", "options": [{"label": "A", "text": "Amitriptyline", "correct": false}, {"label": "B", "text": "Amoxapine", "correct": false}, {"label": "C", "text": "Clomipramine", "correct": false}, {"label": "D", "text": "Imipramine", "correct": true}], "correct_answer": "D. Imipramine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZXZeIILb7TZ4qIQiezVE1749051081.mp3", "video": ""}, {"text": "A 45-year-old woman with a history of major depressive disorder is prescribed amitriptyline for the management of her depression. She has been on the medication for two weeks. . Which of the following side effects is most likely associated with the use of amitriptyline in this patient?", "options": [{"label": "A", "text": "Diarrhea", "correct": false}, {"label": "B", "text": "Bradycardia", "correct": false}, {"label": "C", "text": "Urinary retention", "correct": true}, {"label": "D", "text": "Excessive sweating", "correct": false}], "correct_answer": "C. Urinary retention", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of side effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockade</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sedation, weight gain</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anticholinergic action on <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hyperthermia</li>\n<li>Dry eyes/mouth</li>\n<li>Mydriasis (C/I in glaucoma)</li>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> (option C)</li>\n<li>Constipation (Option A)</li>\n<li>Tachycardia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase in <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> in the brain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Seizure threshold reduction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alpha 1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Postural hypotension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sodium channel block</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Arrhythmia/QT prolongation</li>\n<li>Bradycardia in <span class=\"customMeta\" data-dictid=\"40b788dd6916927771888a3ea6872f\">heart block</span> due to <span class=\"customMeta\" data-dictid=\"3f4eecb1c6169277719459c801fb19\">overdose</span> (Option B)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5a1BpmXqJCfPIyKmryJ81749051281.mp3", "video": ""}, {"text": "Which of the following is false about MAO inhibitors?", "options": [{"label": "A", "text": "Use with sympathomimetics can cause hypertensive crisis", "correct": false}, {"label": "B", "text": "It is contraindicated with tyramine-rich food", "correct": false}, {"label": "C", "text": "Selegiline is a selective MAO-B inhibitor", "correct": false}, {"label": "D", "text": "Routinely used to treat depression", "correct": true}], "correct_answer": "D. Routinely used to treat depression", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:453px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types of <span class=\"customMeta\" data-dictid=\"0307bca2ef1692777191b7df13d4b3\">MAO</span> Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-selective MAOIs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenelzine, Tranylcypromine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective MAO-A inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moclobemide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective MAO-B inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selegiline, Rasagiline (Option C)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bOoOZKzH6iXdXKEjVSg91749051492.mp3", "video": ""}, {"text": "Which of the following atypical antidepressants has the maximum risk of seizures?", "options": [{"label": "A", "text": "Buspirone", "correct": false}, {"label": "B", "text": "Trazodone", "correct": false}, {"label": "C", "text": "Mirtazapine", "correct": false}, {"label": "D", "text": "Buproprion", "correct": true}], "correct_answer": "D. Buproprion", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:649px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bupropion </strong>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Norepinephrine <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> inhibitor</li>\n<li>Used for smoking cessation and weight loss</li>\n<li>High risk of seizures</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trazodone </strong>(Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Serotonin <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> (5HT2 blocker) and <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> inhibitor</li>\n<li>DOC-Depression + <span class=\"customMeta\" data-dictid=\"5cc2a2112e16927771874c5d97065a\">erectile</span> dysfunction</li>\n<li>No sexual <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> side effects</li>\n<li>No <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> side effects</li>\n<li>Can cause priapism</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mirtazapine, Mianserin </strong>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Noradrenaline and selective <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> antagonist</li>\n<li>Side effects: Somnolescence, increased appetite, and weight gain</li>\n<li>Used in depression with insomnia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Buspirone, Gepirone </strong>(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>5HT1a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> partial agonist</li>\n<li>Used to treat generalised anxiety disorder</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tianeptine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Serotonin <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> enhancer</li>\n<li>It also acts on <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors and stimulates them</li>\n<li>Used to treat depression</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zhzRs3kFRMMzANsvjRLa1749051727.mp3", "video": ""}, {"text": "A 30-year-old male presents with fever, altered mental status, tachycardia, rigidity, dilated pupils, clonus, and diarrhea after increasing his SSRI dose. He reports that he recently started taking a new over-the-counter supplement for mood enhancement. The doctor prescribed him cyproheptadine. For which condition is cyproheptadine used as an antidote?", "options": [{"label": "A", "text": "Serotonin syndrome", "correct": true}, {"label": "B", "text": "Tricyclic antidepressant overdose", "correct": false}, {"label": "C", "text": "Rabbit syndrome", "correct": false}, {"label": "D", "text": "Cheese reaction", "correct": false}], "correct_answer": "A. Serotonin syndrome", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JUBxdcGjNvktBlJmzHwD1749051630.mp3", "video": ""}, {"text": "A 45-year-old man presents with complaints of persistent and intractable hiccups for the past 48 hours. He describes the hiccups as occurring every few seconds, significantly affecting his ability to eat, sleep, and carry out daily activities. He denies any recent changes in his diet or lifestyle and has no significant medical history. On examination, he appears anxious and distressed due to the hiccups. Which of the following medications is most appropriate for treating intractable hiccups in this patient?", "options": [{"label": "A", "text": "Thioridazine", "correct": false}, {"label": "B", "text": "Chlorpromazine", "correct": true}, {"label": "C", "text": "Prochlorperazine", "correct": false}, {"label": "D", "text": "Droperidol", "correct": false}], "correct_answer": "B. Chlorpromazine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/joiYvQ8sroTvdI4HnQuh1749051832.mp3", "video": ""}, {"text": "A 70-year-old man with a 10-year history of Parkinson's disease presents to the clinic with complaints of visual hallucinations and delusional thinking, which have been progressively worsening over the past few months. He is started on an atypical antipsychotic to address his psychotic symptoms. Which of the following best describes the mechanism of action of the drug?", "options": [{"label": "A", "text": "Dopamine D2 receptor antagonism", "correct": false}, {"label": "B", "text": "Serotonin 5-HT2A receptor inverse agonism", "correct": true}, {"label": "C", "text": "Dopamine D1 receptor partial agonism", "correct": false}, {"label": "D", "text": "Serotonin 5-HT1A receptor agonism", "correct": false}], "correct_answer": "B. Serotonin 5-HT2A receptor inverse agonism", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:774px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PIMAVANSERIN</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pimavanserin is a novel <span class=\"customMeta\" data-dictid=\"4123308aeb1692777181e8820312dd\">antipsychotic</span> drug.</li>\n<li>Primarily acts through <span class=\"customMeta\" data-dictid=\"459918ac4616927771903ea16da4c9\">inverse</span> agonism of <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> 5-HT2A receptors.</li>\n<li>Does not appreciably bind to 5-HT2B or other <span class=\"customMeta\" data-dictid=\"db2ba2b68d1692777192f2bf39da1f\">monoaminergic</span> receptors.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treats hallucinations and <span class=\"customMeta\" data-dictid=\"1cb2d1482916927771964c2890313e\">psychosis</span> in Parkinson's disease (PD) patients</li>\n<li>Alleviates <span class=\"customMeta\" data-dictid=\"23702653681692777196e5c0fc63cd\">psychotic</span> symptoms without worsening PD motor symptoms</li>\n<li>Lacks <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism, reducing the risk of worsening motor symptoms</li>\n<li>Suitable for PD patients intolerant to traditional antipsychotics (due to <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> effects)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Carries a black-box warning for increased mortality in elderly patients.</li>\n<li>Essential to monitor QT interval due to the risk of QT prolongation and potential <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/u1upsAPzixfKoW31aCS11749051982.mp3", "video": ""}, {"text": "A 42-year-old man has been diagnosed with schizophrenia for over 15 years. Despite multiple trials of antipsychotic medications, including risperidone, olanzapine, and quetiapine, he continues to experience severe and persistent psychotic symptoms. His psychiatrist decides to start clozapine due to the treatment-resistant nature of his schizophrenia. Which of the following does NOT best describe the drug?", "options": [{"label": "A", "text": "Drug choice for resistant mania", "correct": false}, {"label": "B", "text": "Weaker D2 antagonism", "correct": false}, {"label": "C", "text": "Associated with decreased appetite", "correct": true}, {"label": "D", "text": "Wet pillow syndrome is a known side effect", "correct": false}], "correct_answer": "C. Associated with decreased appetite", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:656px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atypical <span class=\"customMeta\" data-dictid=\"4123308aeb1692777181e8820312dd\">antipsychotic</span> with weak <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> D2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism.</p>\n<p>Exhibits potent <span class=\"customMeta\" data-dictid=\"99de407a1516927771818ac910ab5f\">antagonism</span> at <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> 5HT2A receptors.</p>\n<p>Blocks 5HT2A receptors more strongly than D2 receptors.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses of Clozapine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Schizophrenia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC for treatment-resistant schizophrenia.</p>\n<p>Effective for <span class=\"customMeta\" data-dictid=\"d844b672a616927771988fee71197b\">schizophrenia</span> with suicidality, polydipsia, or persistent impulsive aggression.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mania (Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Beneficial as adjunctive therapy or <span class=\"customMeta\" data-dictid=\"e26d71db351692777192bd4e95fc68\">monotherapy</span> for resistant mania.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lower Risk of EPS</p>\n<p>(Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Significantly lower risk of <span class=\"customMeta\" data-dictid=\"e2952dfc311692777187fa773bcc9f\">extrapyramidal</span> symptoms (EPS) due to its weaker D2 <span class=\"customMeta\" data-dictid=\"99de407a1516927771818ac910ab5f\">antagonism</span> compared to typical antipsychotics.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Other Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used to treat antipsychotic-induced <span class=\"customMeta\" data-dictid=\"d93ab38f5316927772001828e5e817\">tardive</span> dyskinesia.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:718px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Serious Adverse Effects of Clozapine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agranulocytosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rare but life-threatening decrease in white blood cells, requiring weekly monitoring.</li>\n<li>Discontinue if total <span class=\"customMeta\" data-dictid=\"00346a7f211692777191e91c2af9fc\">leukocyte</span> count &lt; 3000/mm³ or <span class=\"customMeta\" data-dictid=\"bdfd98a913169277718038aabd961f\">absolute <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> count</span> &lt; 2000/mm³.</li>\n<li>Avoid combining with carbamazepine.</li>\n<li>Monitoring of agranulocytosis: 1st 6 weeks - weekly; Next 6 months- Fortnightly; After 1 year- Monthly</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Seizures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dose-dependent <span class=\"customMeta\" data-dictid=\"5710e3461816927771987151d61aef\">seizure</span> risk. Higher than other <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> antipsychotics.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiac Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Risk of tachycardia, <span class=\"customMeta\" data-dictid=\"b37b57210716927771933ee216a834\">myocarditis</span> (fatal, within first 6 wks) and dilated cardiomyopathy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-serious Adverse effects of Clozapine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypersalivation </strong>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Known as \"wet pillow syndrome\" due to <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Significant risk of weight gain, hyperglycemia, and dyslipidemia.</li>\n<li>Associated with increased <span class=\"customMeta\" data-dictid=\"d4a253810c1692777181f708ba3dc6\">appetite</span> due to 5-HT2C <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockade.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cataracts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Higher risk than other <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> antipsychotics.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect in Pregnancy and Breastfeeding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Can cause decreased <span class=\"customMeta\" data-dictid=\"bf639c9a2316927771825e1632d9fb\">arousal</span> and <span class=\"customMeta\" data-dictid=\"b6a968ad961692777189ce6955627a\">hypotonia</span> in neonates.</li>\n<li>C/I during <span class=\"customMeta\" data-dictid=\"5af45ba59c16927771837f3aa7b6d9\">breastfeeding</span> due to the risk of neutropenia, sedation, and seizures in infants.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M6Upk81WvTlmrjy00aQy1749055864.mp3", "video": ""}, {"text": "Which of the following antipsychotic medications is considered the safest in pregnancy due to its minimal crossing of the placenta?", "options": [{"label": "A", "text": "Olanzapine", "correct": false}, {"label": "B", "text": "Risperidone", "correct": false}, {"label": "C", "text": "Aripiprazole", "correct": false}, {"label": "D", "text": "Quetiapine", "correct": true}], "correct_answer": "D. Quetiapine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2p9v6CnqqxQ4ulzefdgA1749055967.mp3", "video": ""}, {"text": "A 40-year-old woman with a history of schizophrenia has been prescribed an antipsychotic medication for the past few months. She presents to the clinic with complaints of muscle stiffness, restlessness, and occasional tremors. During the examination, the physician noted her difficulty sitting still and observed her hands shaking intermittently. Which of the following symptoms is NOT a presentation associated with antipsychotic drugs?", "options": [{"label": "A", "text": "Tardive dyskinesia", "correct": false}, {"label": "B", "text": "Akathisia", "correct": false}, {"label": "C", "text": "Dystonia", "correct": false}, {"label": "D", "text": "Hyperprolactinemia", "correct": true}], "correct_answer": "D. Hyperprolactinemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:763px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Typical Antipsychotics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Atypical Antipsychotics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Haloperidol - highest risk</li>\n<li>Butyrophenones - potent D2 blockers with a high risk.</li>\n<li>Thioxanthenes -lower <span class=\"customMeta\" data-dictid=\"760a997a7b1692777196db9355b82a\">prolactin</span> risk (least D2 <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> activity)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Risperidone and paliperidone - high risk (due to <strong>￪</strong> <span class=\"customMeta\" data-dictid=\"24226779e7169277719450dba851bc\">P-glycoprotein</span> affinity)</li>\n<li>Pimavanserin and <span class=\"customMeta\" data-dictid=\"8c874bfc1a16927771841a8ad37271\">clozapine</span> - lowest risk.</li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:766px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute muscle <span class=\"customMeta\" data-dictid=\"61747121f116927771862fad303b93\">Dystonia</span> </strong>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Within 1-5 days of starting antipsychotic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Administering <span class=\"customMeta\" data-dictid=\"551a84e8ff16927771811f8a7cb79b\">antiparkinsonian</span> agents such as <span class=\"customMeta\" data-dictid=\"5b2919d86e1692777186240350599b\">diphenhydramine</span> or benztropine intramuscularly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parkinsonism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Within 1 month</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benzhexol and benztropine (NOT Levodopa)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Akathisia</strong> (Option B)</p>\n<p>(Most common EPS)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5–60 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-anxiety medications</p>\n<ol>\n<li>DOC: <span class=\"customMeta\" data-dictid=\"082f7143eb1692777196df69a3b6cb\">Propranolol</span> (C/I: Asthma)</li>\n<li>Diazepam</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rabbit Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Months or years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Antiparkinsonian agents.</li>\n<li>Amantadine is preferred due to less adverse cognitive effects.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tardive <span class=\"customMeta\" data-dictid=\"aa971a0b1c169277718621174b6657\">Dyskinesia</span> </strong>(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Late-onset adverse effect (after months or years)</p>\n<p>Occurs due to D2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"1d640454be16927771999e756dca73\">supersensitivity</span> and can be permanent, even after discontinuing <span class=\"customMeta\" data-dictid=\"4123308aeb1692777181e8820312dd\">antipsychotic</span> medication.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stop <span class=\"customMeta\" data-dictid=\"603878db1116927771812fecb63aec\">AP</span> drugs &amp; start Clozapine.</p>\n<p>If symptoms persist, add <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">Dopamine</span> depleters (VMAT2 inhibitors)</p>\n<ol>\n<li>Valbenazine</li>\n<li>Tetrabenazine: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for Huntington's disease.</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vmHQZhwD4ArMO0ghoabi1749055678.mp3", "video": ""}, {"text": "A 25-year-old man is brought to the emergency department due to severe agitation and aggressive behaviour. The patient has a history of bipolar disorder and is prescribed olanzapine, lithium, and fluoxetine. Temperature is 40.6 C (105.1 F), BP is 157/90 mm Hg. The patient requires several doses of antipsychotics to calm down. Examination shows diffuse rigidity in the upper and lower extremities. Which of the following most likely explains this patient's current symptoms?", "options": [{"label": "A", "text": "Drug-induced parkinsonism", "correct": false}, {"label": "B", "text": "Lithium toxicity", "correct": false}, {"label": "C", "text": "Neuroleptic malignant syndrome", "correct": true}, {"label": "D", "text": "Serotonin Syndrome", "correct": false}], "correct_answer": "C. Neuroleptic malignant syndrome", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:783px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neuroleptic <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">Malignant</span> Syndrome (NMS)</strong><br/>\n\t\t\t(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Serotonin Syndrome</strong><br/>\n\t\t\t(Option D)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Associated with high doses of potent D2 antagonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mediated by <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of 5HT2A and 5HT1A receptors (serotonergic agents)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antipsychotic agents (greater risk with 1st generation than 2nd generation)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>SSRIs, NE <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> inhibitors, triptans, MAOIs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-3 days</p>\n<p>May persist for more than a week after the offending agent is discontinued</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;1 day</p>\n<p>Occur when starting new or increasing <span class=\"customMeta\" data-dictid=\"f4dc45846216927771816608bfe8cd\">antidepressant</span> therapy or combining an <span class=\"customMeta\" data-dictid=\"a52121dd6c169277719913a0fbba72\">SSRI</span> with an NE <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> or a triptan.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common features</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Altered mental status</p>\n<p>Sympathetic <span class=\"customMeta\" data-dictid=\"2e780c7fd416927771895c61217c12\">hyperactivity</span> (eg, hyperthermia, hypertension, tachycardia, diaphoresis)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Distinct features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lead pipe rigidity, hyporeflexia, elevated enzymes (↑ CK), myoglobinuria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clonus, hyperreflexia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cessation of antipsychotic, supportive care (e.g., aggressive <span class=\"customMeta\" data-dictid=\"579dcf5fc51692777185eef17a83c6\">cooling</span> measures), DA <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> (e.g., bromocriptine), dantrolene, ECT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cessation of drugs, benzodiazepines, supportive care, cyproheptadine (serotonin agonist) if symptoms persist.</p>\n<p>Avoid simultaneous <span class=\"customMeta\" data-dictid=\"ff0f0a7e341692777198133f3861c7\">serotonergic</span> agents.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Z8MUSYLo8UdeJtQYNRQq1749055500.mp3", "video": ""}, {"text": "Which of the following antipsychotic medications is typically associated with a higher incidence of akathisia?", "options": [{"label": "A", "text": "Haloperidol", "correct": true}, {"label": "B", "text": "Clozapine", "correct": false}, {"label": "C", "text": "Olanzapine", "correct": false}, {"label": "D", "text": "Risperidone", "correct": false}], "correct_answer": "A. Haloperidol", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Kdjhqy7wyH9g4DeaJsSo1736851086.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qu2KvjnJU8NmeFBsIK6v1749055323.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 26 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which action will not be seen by mu (μ) receptor stimulation?", "options": [{"label": "A", "text": "Strong analgesia", "correct": false}, {"label": "B", "text": "Euphoria", "correct": false}, {"label": "C", "text": "Diuresis", "correct": true}, {"label": "D", "text": "Respiratory depression", "correct": false}], "correct_answer": "C. Diuresis", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:579px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mu receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Kappa receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Delta receptors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">morphine</span> &amp; its congeners.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for ketocyclazocine &amp; <span class=\"customMeta\" data-dictid=\"b485cc881416927771869f5762b827\">dynorphin</span> A.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for Leu/metenkephalins.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Analgesia: <span class=\"customMeta\" data-dictid=\"8e000562c5169277719909eb7c8a17\">Supraspinal</span> (μ<sub>1</sub>) + <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> (μ<sub>2</sub>)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Analgesia: <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> (κ<sub>1</sub>) + <span class=\"customMeta\" data-dictid=\"8e000562c5169277719909eb7c8a17\">Supraspinal</span> (κ<sub>2</sub>)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Analgesia: <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> + affective of supraspinal)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Respiratory depression</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Respiratory depression (minimal)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Respiratory depression</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dysphoria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affective behaviour</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Euphoria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Miosis (minimal)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reinforcing actions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Miosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced GI motility</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscular rigidity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dependence</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Proconvulsant</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced GI motility</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced GI motility</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dependence (morphine type)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GcOaW1FotLcxClPLwiXR1749053863.mp3", "video": ""}, {"text": "A 35-year-old construction worker presents to the emergency department after a crush injury to his lower leg from a collapsed beam. He is in severe pain, with swelling and deformity noted on examination. Vital signs are stable. What is the drug of choice for managing his pain?", "options": [{"label": "A", "text": "Baclofen", "correct": false}, {"label": "B", "text": "Ibuprofen", "correct": false}, {"label": "C", "text": "Morphine", "correct": true}, {"label": "D", "text": "Ketorolac", "correct": false}], "correct_answer": "C. Morphine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3tiJQlw9z8sVoS1Ib9Rq1749053959.mp3", "video": ""}, {"text": "A 58-year-old male presents to the emergency department with severe chest pain radiating to his left arm and jaw. He appears diaphoretic and anxious. On examination, his blood pressure is 160/100 mmHg, heart rate is 110 bpm, and respiratory rate is 24 breaths per minute. An ECG reveals ST-segment elevation in leads II, III, and aVF. Which of the following medications is the most appropriate initial treatment for his severe pain?", "options": [{"label": "A", "text": "Meperidine", "correct": false}, {"label": "B", "text": "Ibuprofen", "correct": false}, {"label": "C", "text": "Nitroglycerin", "correct": false}, {"label": "D", "text": "Morphine", "correct": true}], "correct_answer": "D. Morphine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4ubEIeedtp2iBgTu6HOJ1749054080.mp3", "video": ""}, {"text": "All of the following are true about the pharmacokinetics of morphine except?", "options": [{"label": "A", "text": "Morphine is primarily metabolised by the liver.", "correct": false}, {"label": "B", "text": "Morphine has a long half-life, typically around 2-4 hours.", "correct": false}, {"label": "C", "text": "Morphine undergoes extensive first-pass metabolism when administered orally.", "correct": false}, {"label": "D", "text": "Morphine is primarily eliminated unchanged through the kidneys.", "correct": true}], "correct_answer": "D. Morphine is primarily eliminated unchanged through the kidneys.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetic Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Morphine is metabolized in the liver to <strong>morphine-6-glucuronide</strong> (active) and <strong>morphine-3-glucuronide</strong> (inactive).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>First-pass metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">morphine</span> undergoes significant <strong>first-pass metabolism</strong> in the liver, reducing bioavailability.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <strong>half-life</strong> of <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">morphine</span> is about 2-4 hours intravenously but can be longer orally due to first-pass metabolism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Morphine is <strong>excreted primarily as metabolites</strong> (not unchanged) through the kidneys. The majority of the drug is excreted as <strong>morphine-3-glucuronide</strong> and <strong>morphine-6-glucuronide</strong>.</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absorption:</p>\n<ul>\n<li>Well-absorbed orally, intramuscularly, and subcutaneously</li>\n<li>Distribution: Widely distributed throughout the body, including the CNS; <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein binding ~30-40%</li>\n</ul>\n<p>Metabolism:</p>\n<ul>\n<li>Primarily hepatic, via glucuronidation to morphine-3-glucuronide and morphine-6-glucuronide (active metabolites).</li>\n<li>undergoes minimal <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> when administered intravenously (bypasses first-pass metabolism).</li>\n</ul>\n<p>Excretion:</p>\n<ul>\n<li>Renal (primarily as metabolites); small amounts excreted unchanged in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> and bile.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>Half-life: Approximately 2-4 hours</p>\n<p>Onset of Action: Oral: 30-60 minutes; IV: 5-10 minutes</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZIlM3OGT3oelixuTBcGA1749054218.mp3", "video": ""}, {"text": "Which of the following cough suppressants does not have an addictive potential?", "options": [{"label": "A", "text": "Codeine", "correct": false}, {"label": "B", "text": "Oxycodone", "correct": false}, {"label": "C", "text": "Pholcodine", "correct": false}, {"label": "D", "text": "Noscapine", "correct": true}], "correct_answer": "D. Noscapine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Opioids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Non-opioids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Anti-histamines</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Codeine.</li>\n<li>Ethylmorphine.</li>\n<li>Pholcodine.</li>\n<li>Oxycodone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Noscapine </li>\n<li>Dextromethorphan.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chlorpheniramine.</li>\n<li>Diphenhydramine.</li>\n<li>Promethazine.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4MUM8Jm96uyHCokXbOgq1749054315.mp3", "video": ""}, {"text": "A 32-year-old woman underwent an elective cesarean section at 39 weeks of gestation under spinal anaesthesia. Following the delivery and surgical procedure, she was transferred to the recovery room. Approximately 30 minutes later, she begins to experience intense shivering. Which of the following medications is most appropriate to treat this condition in this patient?", "options": [{"label": "A", "text": "Ondansetron", "correct": false}, {"label": "B", "text": "Meperidine", "correct": true}, {"label": "C", "text": "Midazolam", "correct": false}, {"label": "D", "text": "Ketamine", "correct": false}], "correct_answer": "B. Meperidine", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs used in Post-anesthesia shivering</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Meperidine(DOC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid analgesic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clonidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alpha-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> agonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tramadol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid analgesic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Magnesium sulfate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mineral supplement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ondansetron</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Serotonin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ketamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dissociative anesthetic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Propofol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous <span class=\"customMeta\" data-dictid=\"4b83ec31581692777181547f1a89ef\">anesthetic</span> agent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Physostigmine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetylcholinesterase inhibitor</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rxCJuIUMzPv25GJpjieZ1749054418.mp3", "video": ""}, {"text": "A 35-year-old man presents to the clinic with complaints of muscle aches, insomnia, and intense cravings for opioids. He admits to using heroin for the past five years, often injecting multiple times a day. He has attempted to quit several times but has always relapsed due to severe withdrawal symptoms. He expresses a strong desire to stop using heroin and asks for medical help to manage his addiction. Which of the following is the most effective medication for the treatment?", "options": [{"label": "A", "text": "Naltrexone", "correct": false}, {"label": "B", "text": "Lofexidine", "correct": false}, {"label": "C", "text": "Methadone", "correct": true}, {"label": "D", "text": "Clonidine", "correct": false}], "correct_answer": "C. Methadone", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Opioid Deaddiction Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methadone (DOC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Full <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> agonist; binds to <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors, providing similar effects to other opioids, preventing <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and reducing cravings.</strong></p>\n<p>Methadone maintenance treatment has been used to treat <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> dependence.The <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> dependent patient takes a <span class=\"customMeta\" data-dictid=\"dc3e5778011692777185cf23158fdd\">daily dose</span> of methadone as a liquid or pill. This reduces their <span class=\"customMeta\" data-dictid=\"f5e32d045e16927772027c611a85e2\">withdrawal symptoms</span> and cravings for opioids.</p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Buprenorphine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partial <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> agonist; binds to <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors with a lower maximum effect than full agonists, reducing cravings and withdrawal symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Naltrexone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid antagonist; blocks the effects of opioids at their <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> sites, preventing <span class=\"customMeta\" data-dictid=\"41b8036e5416927771870abd5bdbc2\">euphoria</span> and other <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> effects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lofexidine and Clonidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alpha-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> agonist; reduces the physical symptoms of <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> withdrawal by inhibiting the release of norepinephrine.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zW52b60NxDsKROk5riUy1748860256.mp3", "video": ""}, {"text": "Match the following drugs based on their receptor activity: Drug Receptor 1. Butorphanol a. Partial Mu Agonist + Kappa Antagonists 2. Nalfurafine b. Pure Antagonists 3. Buprenorphine c. Pure Kappa Agonist 4. Naloxone: d. Partial Kappa Agonist + Mu Antagonist", "options": [{"label": "A", "text": "1:a, 2:d, 3:c, 4:b", "correct": false}, {"label": "B", "text": "1:d, 2:c, 3:a, 4:b", "correct": true}, {"label": "C", "text": "1:c, 2:d, 3:a, 4:b", "correct": false}, {"label": "D", "text": "1:b, 2:c, 3:d, 4:a", "correct": false}], "correct_answer": "B. 1:d, 2:c, 3:a, 4:b", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:755px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pure <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">Kappa</span> Agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Partial <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">Kappa</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">Agonist</span> + Mu Antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Partial Mu <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">Agonist</span> + <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">Kappa</span> Antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pure Antagonists</strong></p>\n<p style=\"text-align: center;\"><strong>(competitive block)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nalfurafine</strong></p>\n<p>Fedotozine</p>\n<p>Eluxadoline</p>\n<p>Asimadoline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pentazocine (Partial</p>\n<p>Mu <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> but acts as an antagonist)</p>\n<p>Nalorphine</p>\n<p><strong>Butorphanol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Buprenorphine</strong> (binds mu <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> irreversibly)</p>\n<p>Dezocine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Naloxone</strong></p>\n<p>Naltrexone (longest acting)</p>\n<p>Nalmefene (Liver safe)</p>\n<p>Naloxegol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"7b92610b86169277720111ae27d1d8\">Uremic</span> <span class=\"customMeta\" data-dictid=\"c238cff71916927771965fb88e6cc4\">pruritus</span> in <span class=\"customMeta\" data-dictid=\"e6dc8586b11692777184b083672593\">CKD</span> (Nalfurafine)</p>\n<p>2. Diarrhoea in IBS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">Migraine</span> (Intranasal Butorphanol)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">Opioid</span> deaddiction (Buprenorphine)</p>\n<p>2. <span class=\"customMeta\" data-dictid=\"66ccee483016927771810c2c295d74\">Analgesia</span> (Dezocine)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"5e612ce1381692777181adc76f11e6\">Antidote</span> for <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> (IV Naloxone)</p>\n<p>2. Prevents <span class=\"customMeta\" data-dictid=\"b4b361c37616927771979541177070\">relapse</span> (Naltrexone)</p>\n<p>3. Alcohol <span class=\"customMeta\" data-dictid=\"01be542e8e16927771861e861ab536\">dependence</span> (Nalmefene)</p>\n<p>4. <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">Morphine</span> dependence, <span class=\"customMeta\" data-dictid=\"c5ff3f2d211692777194ddf14e24c4\">obesity</span> (Naltrexone)</p>\n<p>5. Opioid-induced <span class=\"customMeta\" data-dictid=\"281b8ef3701692777185aa34365916\">constipation</span> (Naloxol, methylnaltrexone)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>S/E</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dysphoria or psychosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dysphoria or psychosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Buprenorphine effects cannot be overcome by naloxone.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Naloxone: Hypertension, <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> oedema, arrhythmia</p>\n<p>2. Naltrexone: Hepatotoxic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C/I</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">Opioid</span> deaddiction (precipitate withdrawal)</p>\n<p>2. Myocardial ischemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Labor pain (neonatal <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SGT38NZuP1Q217ldKVCY1749054527.mp3", "video": ""}, {"text": "A 26-year-old student was found unresponsive by his roommate after a party. A physical examination at the hospital revealed constricted pupils with a heart rate of 62 BPM, blood pressure of 90/60 mmHg, and a respiratory rate of 8 per minute. What is the most appropriate initial treatment for this patient's condition?", "options": [{"label": "A", "text": "Intravenous flumazenil", "correct": false}, {"label": "B", "text": "Intravenous naloxone", "correct": true}, {"label": "C", "text": "Gastric lavage with activated charcoal", "correct": false}, {"label": "D", "text": "Forced alkaline diuresis with sodium bicarbonate", "correct": false}], "correct_answer": "B. Intravenous naloxone", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:543px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Opioid Overdose/ Poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cause</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical, <span class=\"customMeta\" data-dictid=\"fb7ff97e071692777180252299cf10\">accidental</span> or suicidal overdose</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Unconsiousness/coma</li>\n<li>Miosis: Pin point pupil</li>\n<li>Respiratory depression</li>\n<li>Dry <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in the eye/mouth</li>\n<li>Urinary retention</li>\n<li>Constipation</li>\n<li>Flaccid muscles</li>\n<li>Convulsions (in children)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Management</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute overdose/poisoning:</strong> IV Naloxone (Antidote)</p>\n<p>↓</p>\n<p><strong>Maintenance</strong> (Detoxification phase: To prevent withdrawal):</p>\n<ul>\n<li>Opioids: Buprenorphine, Methadone, Tramadol</li>\n<li>Non-Opioids- Clonidine, Lofexidine</li>\n</ul>\n<p>↓</p>\n<p><strong>Abstinence</strong> (Prevent relapse):</p>\n<ul>\n<li>DOC: Oral Naltrexone</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VeLsciV4nE31s0E1cpjx1749054643.mp3", "video": ""}, {"text": "Which of the following statements regarding opioid withdrawal symptoms is false? It is a life-threatening condition resulting from chronic opioid dependence Anxiety and irritability are common during early periods of opioid withdrawal. Bradycardia and Sweating are typical symptoms of opioid withdrawal. Buprenorphine is used to reduce withdrawal symptoms and cravings Naloxone is used to treat acute withdrawal symptoms and prevent future relapses.", "options": [{"label": "A", "text": "3 and 5", "correct": true}, {"label": "B", "text": "2, 4, and 5", "correct": false}, {"label": "C", "text": "4 and 5", "correct": false}, {"label": "D", "text": "3, and 4", "correct": false}], "correct_answer": "A. 3 and 5", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Opioid withdrawal </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abruptly stopping chronic use of opioids, including pain medication or illegal drug abuse.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Onset</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>6-12 hours: Short-acting opioids (heroin, fentanyl)</li>\n<li>24-48 hours: Long-acting opioids (oxycodone)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>W (M): Mydriasis</li>\n<li>I: Increased <span class=\"customMeta\" data-dictid=\"76fda07a1f16927772022062e569ff\">yawning</span> (increase respiration), <strong>irritability</strong></li>\n<li>T: Hyperthermia, <strong>Tachycardia</strong></li>\n<li>H: Hyperventilation</li>\n<li>D: <strong>Diarrhea</strong></li>\n<li>R: Rhinorrhea</li>\n<li>A: <strong>Anxiety, sweating</strong></li>\n<li>W (M): Myalgia</li>\n<li>L: Lacrimation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Management</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Deaddiction:</p>\n<ul>\n<li>Start on methadone (long-acting)/ <strong>buprenorphine</strong> (<strong>reduce</strong> <strong>craving</strong>)</li>\n<li>Methadone can be continued safely in pregnant women.</li>\n<li>Taper the dose</li>\n<li>Beta-blocker, Clonidine (symptomatic treatment)</li>\n<li><strong>Naltrexone (Prevent relapse)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pKMnBUX29wrISjWXy1AI1749054932.mp3", "video": ""}, {"text": "A 35-year-old male came to the clinic complaining of constipation for several days. A few weeks ago, he experienced diarrhoea after returning from Thailand, which was resolved after taking loperamide and ornidazole. What medication is best suited for relieving this patient's symptoms", "options": [{"label": "A", "text": "Bisacodyl", "correct": false}, {"label": "B", "text": "Lactulose", "correct": false}, {"label": "C", "text": "Alvimopan", "correct": true}, {"label": "D", "text": "Psyllium", "correct": false}], "correct_answer": "C. Alvimopan", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Representative</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bulk laxatives</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Soluble (Psyllium)</p>\n<p>Insoluble (wheat bran)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Retaining water in stools, increasing</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stool softeners or wetting agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decussate sodium</p>\n<p>Decussate calcium</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Promoting <span class=\"customMeta\" data-dictid=\"fbb10919e516927771917a9afcb633\">luminal</span> water binding by <span class=\"customMeta\" data-dictid=\"24ff542ee616927771865a28edbc12\">detergent</span> action and increasing <span class=\"customMeta\" data-dictid=\"44335bb8bf1692777199a956cb31bf\">stool</span> bulk</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stimulant laxatives</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sodium picosulfate</p>\n<p>Bisacodyl</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increasing intestinal <span class=\"customMeta\" data-dictid=\"69d8ba3cb3169277719543eceaf072\">peristalsis</span> by acting in myenteric plexus; decreasing large <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> water absorption</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osmotic agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Polyethyleneglycol (PEG)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Osmotic water binding</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mixed (not classified)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dried plums</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stool bulking and osmotic action</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1eOc1xgs6fRgDJhHbIvF1749055067.mp3", "video": ""}, {"text": "A 60-year-old male with a history of Parkinson's disease complained of pain after he underwent a laparoscopic inguinal hernia repair a few hours ago. Shortly after taking medication for pain relief, he became agitated and started sweating. Physical examination revealed tachycardia, hyperreflexia, and myoclonus in the legs. Which of the following drugs was most likely given to this patient?", "options": [{"label": "A", "text": "Ibuprofen", "correct": false}, {"label": "B", "text": "Tramadol", "correct": true}, {"label": "C", "text": "Morphine", "correct": false}, {"label": "D", "text": "Oxycodone", "correct": false}], "correct_answer": "B. Tramadol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:312px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs avoided with <span class=\"customMeta\" data-dictid=\"0307bca2ef1692777191b7df13d4b3\">MAO</span> inhibitors: (</strong>Due to risk of <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">Serotonin</span> syndrome)</p>\n<ul>\n<li>Tramadol</li>\n<li>Fentanyl, Meperidine</li>\n<li>Tricyclic depressants (amitriptyline)</li>\n<li>SSRI (sertaline, citalopram etc.)</li>\n<li>Dextromethorphan</li>\n<li>Linezolid</li>\n<li>MDMA, LSD, amphetamine</li>\n<li>Food: <span class=\"customMeta\" data-dictid=\"9264daf7031692777198ba5b8d6e8e\">soy</span> products, red wine, cheese</li>\n<li>Pethidine (causes <span class=\"customMeta\" data-dictid=\"5710e3461816927771987151d61aef\">seizure</span> with MAO-)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DKRwgkcSpCF24jSPjwGC1749055206.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient who was diagnosed with rheumatic heart disease now presents with irregular involuntary movements of the upper limbs and head alongside characteristic darting movement of the tongue. Which of the following drugs is least likely to be used in the management of this presentation?", "options": [{"label": "A", "text": "Trihexyphenidyl", "correct": true}, {"label": "B", "text": "Haloperidol", "correct": false}, {"label": "C", "text": "Sodium valproate", "correct": false}, {"label": "D", "text": "Carbamazepine", "correct": false}], "correct_answer": "A. Trihexyphenidyl", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/e2dZi2IpM3y7RN1fa4111749056149.mp3", "video": ""}, {"text": "A 70-year-old male presents to the hospital with a 2-year history of tremors and rigidity. Physical examination revealed diminished facial expressions and dragging feet while walking. The tremors were reduced when he moved his hand. What is the mechanism of action used by the first-line and the most effective medication in managing this condition?", "options": [{"label": "A", "text": "Increasing dopamine release", "correct": false}, {"label": "B", "text": "Prevents degradation of dopamine", "correct": false}, {"label": "C", "text": "Acting as a dopamine precursor", "correct": true}, {"label": "D", "text": "Blocking acetylcholine receptors", "correct": false}], "correct_answer": "C. Acting as a dopamine precursor", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/iZBOO2p691Wj4N38WQZ11749056318.mp3", "video": ""}, {"text": "A 60-year-old male with a history of glaucoma was recently diagnosed with primary Parkinson's disease and started treatment with syndopa (levodopa-carbidopa) therapy. The patient inquires about potential adverse events associated with the treatment. Which of the following statements is false? Nausea is the most common adverse effect due to the activation of D2 receptors inside the GIT. Dyskinesias and impulsiveness are common adverse effects associated with long-term levodopa use. Levodopa is contraindicated in this patient with a history of narrow-angle glaucoma. Long-term use of levodopa is associated with fluctuations in motor symptoms. Levodopa increases treatment efficacy with carbidopa.", "options": [{"label": "A", "text": "1, 3 and 5", "correct": false}, {"label": "B", "text": "Only 1", "correct": true}, {"label": "C", "text": "2 and 5", "correct": false}, {"label": "D", "text": "3 and 4", "correct": false}], "correct_answer": "B. Only 1", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:645px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse events associated with Levodopa</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> side effects:</p>\n<ul>\n<li><strong>Nausea/ vomiting: (Statement 1)</strong>\n<ul>\n<li><strong>Most common</strong></li>\n<li>Due to D2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> in CTZ <strong>outside</strong> the <strong>blood-brain barrier</strong>.</li>\n<li>Treat with <span class=\"customMeta\" data-dictid=\"5c3d9685cb1692777186c363b661a3\">domperidone</span> (Blocks D2 receptor)</li>\n</ul>\n</li>\n<li><strong>Postural hypotension</strong> (D1 receptor-induced vasodilation)</li>\n<li>Mydriasis (Stimulates alpha-1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> in the iris)</li>\n<li>Arrhythmia (Stimulates <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> beta-1 receptor)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Note: </strong>Combining <span class=\"customMeta\" data-dictid=\"398108f4501692777191f60f958fb2\">Levodopa</span> with <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"97ddcfb7961692777186e4dfd6dbc2\">dopa</span> <span class=\"customMeta\" data-dictid=\"71aa164f75169277718559680376bd\">decarboxylase</span> inhibitors (Carbidopa/Bensarazide) prevents <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> side effects. <strong>(Statement 5)</strong></p>\n\t\t\t \n\n\t\t\t<p>2. CNS side effects:</p>\n<ul>\n<li><strong>Dyskinesia</strong>: Treat with Amantadine, Levetiracetam <strong>(Statement 2)</strong></li>\n<li>Psychosis: Clozapine, Quetiapine</li>\n<li>Hypersexuality/<strong>impulsiveness</strong></li>\n</ul>\n\t\t\t \n\n\t\t\t<p>3. Wearing off phenomenon</p>\n<ul>\n<li>Reduced effect of <span class=\"customMeta\" data-dictid=\"398108f4501692777191f60f958fb2\">levodopa</span> with decreased <span class=\"customMeta\" data-dictid=\"17d10546871692777193f302d45980\">neuron</span> number</li>\n</ul>\n<p> </p>\n<p>4. <strong>On-off phenomenon: (Statement 4)</strong></p>\n<ul>\n<li><strong>Fluctuating</strong> course of improved <span class=\"customMeta\" data-dictid=\"650eb29fb9169277719270ea0fbea5\">mobility</span> followed by akinesia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Angle-closure <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> </strong>(block trabecular outflow) <strong>(Statement 3)</strong> </li>\n<li>Melanoma</li>\n<li>Peptic Ulcer Disease</li>\n<li>Psychosis</li>\n<li>In combination with vitamin B6/pyridoxine (increase <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> conversion and side effects)</li>\n<li>In combination with MAO inhibitors (hypertensive crisis)</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HQdrj4IF53rvEdp2kXuc1749056657.mp3", "video": ""}, {"text": "A patient who was diagnosed with Parkinson’s disease and started on syndopa a few months ago now complains of worsening rigidity and dyskinesia in between brief periods of improvement. Which of the following is the least preferred add-on drug for this patient?", "options": [{"label": "A", "text": "Istradefylline", "correct": false}, {"label": "B", "text": "Entacapone", "correct": false}, {"label": "C", "text": "Apomorphine", "correct": false}, {"label": "D", "text": "Tolcapone", "correct": true}], "correct_answer": "D. Tolcapone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:527px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>“On” Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Periods of good motor function after <span class=\"customMeta\" data-dictid=\"398108f4501692777191f60f958fb2\">levodopa</span> dose</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>“Off” Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sudden return of <span class=\"customMeta\" data-dictid=\"af42cffef41692777194ceaa162eeb\">parkinsonian</span> symptoms as drug effect wanes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wearing Off</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gradual decline in drug <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> before next dose</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Freezing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Temporary inability to initiate movement (usually in “off” state)</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class/Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use in On-Off</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Remarks</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Entacapone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>COMT inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"398108f4501692777191f60f958fb2\">levodopa</span> breakdown</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prolongs “on” time</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preferred COMT inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tolcapone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>COMT inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits central + <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> COMT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Similar effect but with hepatotoxicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Least preferred</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Apomorphine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dopamine <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> (rescue)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct D1/D2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used for <strong>sudden “off” episodes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapid-acting, subcutaneous</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Istradefylline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenosine A2A antagonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enhances <span class=\"customMeta\" data-dictid=\"6aec63ba2e1692777186e5809a7376\">dopaminergic</span> activity in <span class=\"customMeta\" data-dictid=\"2f73e160ba1692777190d65065c95b\">indirect</span> pathway</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces “off” periods</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Favorable side-effect profile</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Selegiline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MAO-B inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> metabolism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces wearing-off effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neuroprotective role suggested</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amantadine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NMDA antagonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> release, reduces glutamate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used for <strong>levodopa-induced dyskinesia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Add-on in advanced stages</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/r0QsiGXvrUq1wpShgdbn1747297874.mp3", "video": ""}, {"text": "A patient was diagnosed with Parkinson’s disease and started on drugs for the same 6 months ago. She now presents for a review with complaints of skin discolouration, as shown in the image below. Which of the following antiparkinson agents would have caused this presentation?", "options": [{"label": "A", "text": "Rasagiline", "correct": false}, {"label": "B", "text": "Trihexyphenidyl", "correct": false}, {"label": "C", "text": "Amantadine", "correct": true}, {"label": "D", "text": "Ropinirole", "correct": false}], "correct_answer": "C. Amantadine", "question_images": ["https://image.prepladder.com/notes/OfiSglrED4Y8bj4mSJR21746127222.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AJGT3rVpC5d05IAZWoDr1746258473.mp3", "video": ""}, {"text": "All of the following are true regarding non-ergot derivatives used in Parkinson’s disease, except?", "options": [{"label": "A", "text": "Symptoms improve with pramipexole much quicker than with bromocriptine", "correct": false}, {"label": "B", "text": "Ropinirole can be used as an add-on drug during the on-off phase", "correct": false}, {"label": "C", "text": "The efficacy of apomorphine improves when combined with ondansetron", "correct": true}, {"label": "D", "text": "Ropinirole proves best in managing restless leg syndrome", "correct": false}], "correct_answer": "C. The efficacy of apomorphine improves when combined with ondansetron", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ug2deRQv6gk63RSTpWpb1749056857.mp3", "video": ""}, {"text": "A 55-year-old patient who was diagnosed with schizophrenia and started on risperidone 4 months ago now presents with resting tremors, muscular rigidity in the upper limbs and reduced pace in movements. Which of the following is the most appropriate drug of choice for this patient ?", "options": [{"label": "A", "text": "Rasagiline", "correct": false}, {"label": "B", "text": "Bromocriptine", "correct": false}, {"label": "C", "text": "Amantadine", "correct": false}, {"label": "D", "text": "Benzhexol", "correct": true}], "correct_answer": "D. Benzhexol", "question_images": ["https://image.prepladder.com/content/bfJ7HsO0yvVOZbIHJlVw1724255103.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8a1no1URgEFlHCHLV3UD1749056980.mp3", "video": ""}, {"text": "A patient who was diagnosed with rheumatic heart disease now presents with irregular involuntary movements of the upper limbs and head alongside characteristic darting movement of the tongue. Which of the following drugs is least likely to be used in the management of this presentation?", "options": [{"label": "A", "text": "Trihexyphenidyl", "correct": true}, {"label": "B", "text": "Haloperidol", "correct": false}, {"label": "C", "text": "Sodium valproate", "correct": false}, {"label": "D", "text": "Carbamazepine", "correct": false}], "correct_answer": "A. Trihexyphenidyl", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Ky7nl2rfxCKABleJUyQh1749057114.mp3", "video": ""}, {"text": "A patient who presented with progressive muscle weakness and atrophy alongside dysarthria is diagnosed with Lou Gehrig’s disease. All of the following drugs can be used to manage this condition except?", "options": [{"label": "A", "text": "Tizanidine", "correct": false}, {"label": "B", "text": "Donepezil", "correct": true}, {"label": "C", "text": "Edaravone", "correct": false}, {"label": "D", "text": "Riluzole", "correct": false}], "correct_answer": "B. Donepezil", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:652px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct action on the nervous system</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptomatic (relieve spasticity)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Riluzole.</li>\n<li>Edaravone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Baclofen.</li>\n<li>Tizanidine.</li>\n<li>Clonazepam (should be used cautiously as it can cause <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression in advanced ALS).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vYeqowhFaps6G40kLAG31748866916.mp3", "video": ""}, {"text": "Which of the following is the drug of choice in a child with Rett syndrome?", "options": [{"label": "A", "text": "Lonafarnib", "correct": false}, {"label": "B", "text": "Omaveloxolone", "correct": false}, {"label": "C", "text": "Trofinetide", "correct": true}, {"label": "D", "text": "Ocrelizumab", "correct": false}], "correct_answer": "C. Trofinetide", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lonafarnib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Progeria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Omaveloxolone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Friedreich’s ataxia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ocrelizumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple sclerosis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/el1He66KuDuGdEmnhTtr1749057200.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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To monitor the blood lithium levels, at what time interval should the blood sample be collected after the administration of lithium tablets?", "options": [{"label": "A", "text": "After 24 hours", "correct": false}, {"label": "B", "text": "After 12 hours", "correct": true}, {"label": "C", "text": "After 6 hours", "correct": false}, {"label": "D", "text": "Immediately after taking tablets", "correct": false}], "correct_answer": "B. After 12 hours", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - After 12 hou\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication could potentially cause constipation, blurred vision, and dry mouth in a 70-year-old patient with a history of schizophrenia receiving treatment for drug-induced Parkinson's disease?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Pramipexole", "correct": false}, {"label": "C", "text": "Benzhexol", "correct": true}, {"label": "D", "text": "Selegiline", "correct": false}], "correct_answer": "C. Benzhexol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Benzh\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Anticholinergic</p>\n</td>\n<td>\n<p>Benzhexol, Trihexyphenidyl, Biperiden</p>\n</td>\n<td>\n<p>Blockade of <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors in the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> ganglia</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Dopamine agonist</p>\n</td>\n<td>\n<p>Pramipexole, Ropinirole</p>\n</td>\n<td>\n<p>Direct <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> receptors</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Beta-blocker</p>\n</td>\n<td>\n<p>Propranolol</p>\n</td>\n<td>\n<p>Blockade of beta-receptors in the brain</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>GABA agonist</p>\n</td>\n<td>\n<p>Baclofen</p>\n</td>\n<td>\n<p>Enhancement of GABA-mediated <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> in the CNS</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Amantadine</p>\n</td>\n<td>\n<p>Amantadine</p>\n</td>\n<td>\n<p>Enhancement of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> release and <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of reuptake</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Vitamins</p>\n</td>\n<td>\n<p>Vitamin E</p>\n</td>\n<td>\n<p>An <span class=\"customMeta\" data-dictid=\"1f3c08447d16927771819ccd566468\">antioxidant</span> effect that may reduce <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> damage in the CNS</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding memantine? Its therapeutic effect is due to its action on NMDA It is reserved for moderate to severe diseases. It is used as monotherapy and should not be used with other cholinesterase inhibitors . It is given at a daily dose of 1- 30 mg / day.", "options": [{"label": "A", "text": "1,2,3,4", "correct": false}, {"label": "B", "text": "1,2", "correct": true}, {"label": "C", "text": "3,4", "correct": false}, {"label": "D", "text": "1,2,3", "correct": false}], "correct_answer": "B. 1,2", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Memantine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NMDA (N-Methyl-D-Aspartate) <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>NMDA <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist: Memantine works by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> <span class=\"customMeta\" data-dictid=\"000b76a37716927771932ba41c5089\">NMDA</span> receptors (which are <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors) in the brain.</li>\n<li>Modulates <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> activity without completely <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> it, reducing excessive <span class=\"customMeta\" data-dictid=\"62ff9f17e5169277718804ead36311\">glutamatergic</span> <span class=\"customMeta\" data-dictid=\"66748a30e91692777193358c35b2b0\">neurotransmission</span> that can lead to <span class=\"customMeta\" data-dictid=\"2a551d28831692777193c0dfd8e352\">neurotoxicity</span> in Alzheimer's disease.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Alzheimer's Disease (moderate to severe stage)</li>\n<li>Dementia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Headache, Dizziness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypersensitivity to memantine or any of its components</li>\n<li>Used with caution in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> due to the drug's <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> elimination.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following side effects is more commonly seen with oxcarbazepine than with carbamazepine?", "options": [{"label": "A", "text": "Hypotension", "correct": false}, {"label": "B", "text": "Hyponatremia", "correct": true}, {"label": "C", "text": "Rash", "correct": false}, {"label": "D", "text": "Elevated levels of gamma-glutamyl transpeptidases", "correct": false}], "correct_answer": "B. Hyponatremia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects of Carbamazepine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Neurotoxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sedation, dizziness, vertigo, diplopia, and ataxia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Gastrointestinal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vomiting and diarrhoea occur with higher doses.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Acute Intoxication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coma, convulsions, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> collapse.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Haematological</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agranulocytosis, <span class=\"customMeta\" data-dictid=\"1ea06afcbd1692777181199bfa3300\">aplastic</span> anaemia.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hypersensitivity Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rashes <strong>(Option C)</strong>, photosensitivity, hepatitis, lupus-like syndrome.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Water <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">Retention</span> and Hyponatremia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to enhanced <span class=\"customMeta\" data-dictid=\"27bd08bbaa16927771812e98e16787\">antidiuretic</span> hormone (ADH) action, it is more common in the elderly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Teratogenicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"17cd3771bb1692777190950c142dbe\">incidence</span> of minor <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hepatic function</strong></p>\n<p style=\"text-align: center;\"><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is associated with <strong>elevated levels of gamma-glutamyl transpeptidase (GGT)</strong>-liver enzymes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hypotension</strong></p>\n<p style=\"text-align: center;\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It can cause hypotension, particularly <span class=\"customMeta\" data-dictid=\"32742bce4316927771941ff62a9db7\">orthostatic</span> hypotension, due to its CNS <span class=\"customMeta\" data-dictid=\"974aacc9c716927771867653a1dd71\">depressant</span> effects, <strong>it is not very common.</strong></li>\n<li>Oxcarbazepine, although structurally similar, tends to have a lower <span class=\"customMeta\" data-dictid=\"17cd3771bb1692777190950c142dbe\">incidence</span> of hypotension.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient is brought with altered sensorium and seizures. The attendant showed the laboratory report, which revealed elevated transaminases. Which of the following can be used in this condition?", "options": [{"label": "A", "text": "Midazolam", "correct": false}, {"label": "B", "text": "Diazepam", "correct": false}, {"label": "C", "text": "Alprazolam", "correct": false}, {"label": "D", "text": "Oxazepam", "correct": true}], "correct_answer": "D. Oxazepam", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is false regarding disulfiram? Does not stop cravings Accumulates acetaldehyde Inhibits alcohol dehydrogenase Maintenance dose is 250 mg", "options": [{"label": "A", "text": "Only 3", "correct": true}, {"label": "B", "text": "1 and 3", "correct": false}, {"label": "C", "text": "1,3 and 4", "correct": false}, {"label": "D", "text": "2,3 and 4", "correct": false}], "correct_answer": "A. Only 3", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 29-year-old woman presented to the psychiatry outpatient department (OPD) exhibiting symptoms of hypomania. She has a previous history of a manic episode. Currently, she is considering pregnancy. Which medication should be avoided due to its high teratogenic potential for the developing fetus?", "options": [{"label": "A", "text": "Valproate", "correct": true}, {"label": "B", "text": "Lithium", "correct": false}, {"label": "C", "text": "Oxcarbazepine", "correct": false}, {"label": "D", "text": "Olanzapine", "correct": false}], "correct_answer": "A. Valproate", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who is a known addict is brought to the hospital due to intoxication with an unknown substance. An ocular examination shows the following finding. Which of the following is true regarding this condition?", "options": [{"label": "A", "text": "This action can be reversed by phenylephrine", "correct": false}, {"label": "B", "text": "It cannot be reversed by levallorphan", "correct": false}, {"label": "C", "text": "It is caused by activation of the Edinger- Westphal nucleus", "correct": true}, {"label": "D", "text": "Tolerance develops due to long-term use", "correct": false}], "correct_answer": "C. It is caused by activation of the Edinger- Westphal nucleus", "question_images": ["https://image.prepladder.com/notes/M37t1XbHkDjuaN0X9HIX1746709572.png"], "explanation_images": ["https://image.prepladder.com/notes/t9DORkAIZLHxJWjPJhAM1745482449.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Opioid Overdose/ Poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Management</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute overdose/poisoning:</strong> IV Naloxone (Antidote)</p>\n<p>↓</p>\n<p><strong>Maintenance</strong> (Detoxification phase: To prevent withdrawal):</p>\n<ul>\n<li>Opioids: Buprenorphine, Methadone, Tramadol</li>\n<li>Non-Opioids- Clonidine, Lofexidine</li>\n</ul>\n<p>↓</p>\n<p><strong>Abstinence</strong> (Prevent relapse):</p>\n<ul>\n<li>DOC: Oral Naltrexone</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The parents of a 9-year-old girl have noticed their daughter often staring blankly, which is sometimes associated with chewing movements. There were also complaints of daydreaming and a decline in school performance. During the episodes, she did not have a problem with maintaining posture, nor were there generalised tonic and clonic movements. The child's EEG is given below. Which of the following is a first-line agent to treat this condition?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Sodium valproate", "correct": true}, {"label": "D", "text": "Clonazepam", "correct": false}], "correct_answer": "C. Sodium valproate", "question_images": ["https://image.prepladder.com/notes/19DnLPiIiK5wg7S0SCv51747899744.png"], "explanation_images": [], "explanation": "<p>Correct Answer C - Sodium v\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with symptoms of psychosis is prescribed aripiprazole. Which of the following best describes this drug when compared to other antipsychotic drugs?", "options": [{"label": "A", "text": "No intrinsic activity, high affinity for D2 receptor, less extrapyramidal symptoms, andmore weight gain", "correct": false}, {"label": "B", "text": "High intrinsic activity, no affinity for D2 receptor, more extrapyramidal symptoms, and less weight gain", "correct": false}, {"label": "C", "text": "Low intrinsic activity, high affinity for D2 receptor, less extrapyramidal symptoms, and less weight gain", "correct": true}, {"label": "D", "text": "High intrinsic activity, high affinity for D2 receptor, less extrapyramidal symptoms, and less weight gain", "correct": false}], "correct_answer": "C. Low intrinsic activity, high affinity for D2 receptor, less extrapyramidal symptoms, and less weight gain", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Low &lt;span class=\"customMeta\" data-dictid=\"a6795c876e169277719057a1099465\"&gt;intrinsic&lt;/span&gt; activity, high &lt;span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\"&gt;affinity&lt;/span&gt; for D2 receptor, less &lt;span class=\"customMeta\" data-dictid=\"e2952dfc311692777187fa773bcc9f\"&gt;extrapyramidal&lt;/span&gt; symptoms, and less weight g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antidepressant drugs acts by inhibiting the reuptake of both serotonin and norepinephrine?", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Venlafaxine", "correct": true}, {"label": "C", "text": "Paroxetine", "correct": false}, {"label": "D", "text": "Dapoxetine", "correct": false}], "correct_answer": "B. Venlafaxine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Venlafaxine</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>SSRI (Selective <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">Serotonin</span> <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">Reuptake</span> Inhibitors)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<ul>\n<li>Fluoxetine <strong>(Option A)</strong></li>\n<li>Paroxetine <strong>(Option C)</strong></li>\n<li>Sertralin</li>\n<li>Citalopram</li>\n<li>Escitalopram</li>\n<li>Dapoxetine <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>SNRI (Serotonin-Norepinephrine <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">Reuptake</span> Inhibitors)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<ul>\n<li>Venlafaxine</li>\n<li>Duloxetine</li>\n<li>Desvenlafaxine</li>\n<li>Milnacipran</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>TCA (Tricyclic Antidepressants)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<ul>\n<li>Amitriptyline</li>\n<li>Nortriptyline</li>\n<li>Imipramine</li>\n<li>Clomipramine</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which neurotransmitter is primarily responsible for the condition observed in a 55-year-old male who presents with rigidity, frequent falls, slowness in movements, tremors, and a short stepping gait?", "options": [{"label": "A", "text": "GABA", "correct": false}, {"label": "B", "text": "Acetylcholine", "correct": false}, {"label": "C", "text": "Dopamine", "correct": true}, {"label": "D", "text": "Serotonin", "correct": false}], "correct_answer": "C. Dopamine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - D\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not an off-label use of risperidone?", "options": [{"label": "A", "text": "Obsessive impulsive disorder", "correct": false}, {"label": "B", "text": "Dementia", "correct": false}, {"label": "C", "text": "PTSD", "correct": false}, {"label": "D", "text": "Bipolar disorder", "correct": true}], "correct_answer": "D. Bipolar disorder", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Risperidone</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Risperidone is an <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> <span class=\"customMeta\" data-dictid=\"4123308aeb1692777181e8820312dd\">antipsychotic</span> medication that is approved by the FDA for the treatment of schizophrenia and <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder (both <span class=\"customMeta\" data-dictid=\"ff42ad0e5716927771914cad2ccde9\">manic</span> and mixed episodes)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>MOA</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Antagonism at D2 and 5 HT2 receptors</p>\n<p>Also binds <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 1 and 2 receptor, and the H1 receptor</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>FDA approved</p>\n<ul>\n<li>Long-term management of <span class=\"customMeta\" data-dictid=\"1cb2d1482916927771964c2890313e\">psychosis</span> and schizophrenia</li>\n<li>Maintenance therapy in <span class=\"customMeta\" data-dictid=\"51c142d5d116927771912526695796\">mania</span> <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder</li>\n<li>Management of <span class=\"customMeta\" data-dictid=\"982688ae75169277719041afa70c42\">irritability</span> in <span class=\"customMeta\" data-dictid=\"59f989084e16927771822f692979f5\">autism</span> spectrum disorder</li>\n</ul>\n<p> </p>\n<p>Off label uses</p>\n<ul>\n<li>Management of <span class=\"customMeta\" data-dictid=\"1cb2d1482916927771964c2890313e\">psychosis</span> in <span class=\"customMeta\" data-dictid=\"74ef5626ab16927771855274381e00\">delirium</span> and dementia (Option B)</li>\n<li>Obsessive-compulsive disorders (Option A)</li>\n<li>PTSD (Option C)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Adverse effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Hyperprolactinemia</li>\n<li>Cardiovascular accident</li>\n<li>Extrapyramidal side effects</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-epileptic drugs can also be used to treat neuropathic pain? Pregabalin Carbamazepine Lamotrigine Gabapentin", "options": [{"label": "A", "text": "1, 2 and 3", "correct": false}, {"label": "B", "text": "1, 2 and 4", "correct": true}, {"label": "C", "text": "1, 3 and 4", "correct": false}, {"label": "D", "text": "2 and 4 only", "correct": false}], "correct_answer": "B. 1, 2 and 4", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Drug</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Mechanism of Action</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Side Effects</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Carbamazepine</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Inhibits high-frequency neuronal discharges and modulates voltage-gated sodium channels.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Trigeminal neuralgia</p>\n<p>GTCS, partial seizures, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Sedation, dizziness, ataxia, GI disturbances, <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> suppression, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions, water retention.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Gabapentin</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Enhances GABA release modulates voltage-sensitive Ca2+ channels.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Partial seizures, post-herpetic neuralgia,</p>\n<p>Peripheral <span class=\"customMeta\" data-dictid=\"2d9476094c16927771933bcb162f19\">neuropathy</span> <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> prophylaxis</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Sedation, tiredness, dizziness, tremor, unsteadiness.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Pregabalin</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Selectively binds to the α2-δ subunit of voltage-gated <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels and reduces <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> release.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Diabetic neuropathy, Post-herpetic neuralgia, Fibromyalgia and Spinal cord injury.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Topiramate is used for which of the following?", "options": [{"label": "A", "text": "Treatment of Acute migraine", "correct": false}, {"label": "B", "text": "Treatment of Lennox-Gastaut syndrome", "correct": true}, {"label": "C", "text": "Prophylaxis of ADHD", "correct": false}, {"label": "D", "text": "Treatment of Dementia", "correct": false}], "correct_answer": "B. Treatment of Lennox-Gastaut syndrome", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Treatment of &lt;span class=\"customMeta\" data-dictid=\"f90c6de26b16927771916123e25f61\"&gt;Lennox-Gastaut syndrome&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Topiramate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reduces voltage-gated sodium currents in cerebellar <span class=\"customMeta\" data-dictid=\"fd69fc99d41692777188cc051aafa5\">granule</span> cells.</li>\n<li>Activated hyperpolarising <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> current, which enhances GABA-A receptor</li>\n<li>Limits the <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of AMPA-kainate subtype of <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors.</li>\n<li>Modulationof the activity of <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> and glutamate</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Focal and primary generalized epilepsy</li>\n<li>Refractory <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> epilepsy</li>\n<li>Lennox-Gastaut syndrome (LGS)</li>\n<li>Prophylaxis of migraine</li>\n<li>Obesity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pharmacokinetics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>20% is <span class=\"customMeta\" data-dictid=\"d82fcb9d1f16927771836a9f6ccf14\">bound</span> to <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> proteins</li>\n<li>Excreted in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> unchanged with a t1/2 of 24 hours</li>\n<li>Enzyme <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> occurs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Somnolence, weight loss, fatigue, nervousness</li>\n<li>Renal <span class=\"customMeta\" data-dictid=\"eae898f16d1692777183cc3469a664\">calculi</span> formation</li>\n<li>Cognitive impairment</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is most likely responsible for visual disturbances and contraction of the visual field in a patient who was taking antiepileptics for seizure management?", "options": [{"label": "A", "text": "Phenobarbitone", "correct": false}, {"label": "B", "text": "Vigabatrin", "correct": true}, {"label": "C", "text": "Ethosuximide", "correct": false}, {"label": "D", "text": "Levetiracetam", "correct": false}], "correct_answer": "B. Vigabatrin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Vigabatrin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ophthalmic side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Vigabatrin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Significant risk of permanent <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> defects (visual field constriction) and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Topiramate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Potential for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> myopia, secondary angle-closure glaucoma, and visual disturbances such as blurred vision and diplopia.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is correct?", "options": [{"label": "A", "text": "Maximum oral dose of fosphenytoin causes cerebellar degeneration and brain atrophy.", "correct": false}, {"label": "B", "text": "High doses of fosphenytoin cause cardiotoxicity in elderly patients and nephrotoxicity in young patients", "correct": true}, {"label": "C", "text": "The safe dose of phenytoin is 250 mg/kg.", "correct": false}, {"label": "D", "text": "Fosphenytoin is given to all seizure patients in the ER regardless of CNS side effects and hypertension.", "correct": false}], "correct_answer": "B. High doses of fosphenytoin cause cardiotoxicity in elderly patients and nephrotoxicity in young patients", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antidepressants causes the least sexual dysfunction?", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Venlafaxine", "correct": false}, {"label": "C", "text": "Mirtazapine", "correct": true}, {"label": "D", "text": "Imipramine", "correct": false}], "correct_answer": "C. Mirtazapine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For a patient who has commenced lithium therapy, which of the following adverse effects should they be instructed to be vigilant for in order to detect any signs of toxicity?", "options": [{"label": "A", "text": "Malaise and sore throat", "correct": false}, {"label": "B", "text": "Vertigo and Diarrhoea", "correct": true}, {"label": "C", "text": "Fever", "correct": false}, {"label": "D", "text": "Breathlessness", "correct": false}], "correct_answer": "B. Vertigo and Diarrhoea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"7d489fad971692777201210257b018\"&gt;Vertigo&lt;/span&gt; and Diarrh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable cause for the development of respiratory difficulty in a patient who received intravenous morphine for pain relief after a road traffic accident, considering the presence of pelvic fracture and head trauma?", "options": [{"label": "A", "text": "Pelvic Fracture", "correct": false}, {"label": "B", "text": "CO₂ retention due to opioid use", "correct": true}, {"label": "C", "text": "Cerebral Edema", "correct": false}, {"label": "D", "text": "Pulmonary embolism", "correct": false}], "correct_answer": "B. CO₂ retention due to opioid use", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - CO₂ &lt;span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\"&gt;retention&lt;/span&gt; due to &lt;span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\"&gt;opioid&lt;/span&gt; u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the below statements is accurate regarding disulfiram?", "options": [{"label": "A", "text": "When used with alcohol, the patients feel drowsy, with chest discomfort and respiratory depression", "correct": true}, {"label": "B", "text": "It is an anticraving drug", "correct": false}, {"label": "C", "text": "It can be initiated even in minimally motivated persons", "correct": false}, {"label": "D", "text": "Its action persists up to 2-3 days after stopping the drug", "correct": false}], "correct_answer": "A. When used with alcohol, the patients feel drowsy, with chest discomfort and respiratory depression", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - When used with alcohol, the patients feel drowsy, with chest discomfort and &lt;span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\"&gt;respiratory&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the main concern when considering the discharge of a patient who has been treated with Tricyclic antidepressants (TCAs) for a major depressive episode in the hospital for 4 weeks?", "options": [{"label": "A", "text": "Need for drug monitoring", "correct": false}, {"label": "B", "text": "ECG monitoring for arrhythmias", "correct": false}, {"label": "C", "text": "Suicidal risk", "correct": true}, {"label": "D", "text": "Sedation being the side effect", "correct": false}], "correct_answer": "C. Suicidal risk", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Suicidal risk\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs are used for absence seizures? A. Carbamazepine B. Valproate C. Ethosuximide D. Gabapentin", "options": [{"label": "A", "text": "A, B, and C", "correct": false}, {"label": "B", "text": "B and C only", "correct": true}, {"label": "C", "text": "B only", "correct": false}, {"label": "D", "text": "A, B and D", "correct": false}], "correct_answer": "B. B and C only", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - B and C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true? A. Morphine is used in pulmonary edema B. Pethidine is used in biliary colic C. Indomethacin is used for headache D. Aspirin is used in peptic ulcer disease", "options": [{"label": "A", "text": "A and C", "correct": false}, {"label": "B", "text": "A, B, and C", "correct": true}, {"label": "C", "text": "A and D", "correct": false}, {"label": "D", "text": "B, C, and D", "correct": false}], "correct_answer": "B. A, B, and C", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with biliary colic to the ER. The intern administered an analgesic, which worsened the pain. Which of the following drugs could be responsible for aggravation of the patient’s symptoms?", "options": [{"label": "A", "text": "Morphine", "correct": true}, {"label": "B", "text": "Diclofenac", "correct": false}, {"label": "C", "text": "Nefopam", "correct": false}, {"label": "D", "text": "Etoricoxib", "correct": false}], "correct_answer": "A. Morphine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female patient has been on first-line pharmacological therapy for bipolar disorder for the past 6 months. She has been fasting for the past few days due to religious reasons, and she was presented with seizures, coarse tremors, confusion and weakness of limbs. Which of the following investigations should be done to aid in her diagnosis?", "options": [{"label": "A", "text": "Serum potassium levels", "correct": false}, {"label": "B", "text": "Serum lithium levels", "correct": true}, {"label": "C", "text": "ECG", "correct": false}, {"label": "D", "text": "MRI", "correct": false}], "correct_answer": "B. Serum lithium levels", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Grade </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Serum <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> (mEq/L)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mild </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1.5 - 2.5</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nausea, vomiting, tremor, fatigue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderate </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2.5 - 3.5</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Confusion, agitation, delirium, tachycardia, hypertonia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Severe </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>&gt; 3.5</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Seizures, hyperthermia, hypotension, Coma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs acts by inhibiting the catechol-o-methyl transferase enzyme?", "options": [{"label": "A", "text": "Amantidine", "correct": false}, {"label": "B", "text": "Rotigotine", "correct": false}, {"label": "C", "text": "Tolcapone", "correct": true}, {"label": "D", "text": "Selegiline", "correct": false}], "correct_answer": "C. Tolcapone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Tolcapone</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Tolcapone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It inhibits the catechol-o-methyl <span class=\"customMeta\" data-dictid=\"2288cbf3741692777200318d2f5b39\">transferase</span> enzyme, which is responsible for the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of catecholamines, which prolongs the action of catechols in the <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> tissue.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Adjunct therapy in Parkinson’s disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hepatotoxicity</li>\n<li>On/Off phenomenon</li>\n</ul>\n<p>Neurological Symptoms:</p>\n<ul>\n<li>Dyskinesia (due to increased <span class=\"customMeta\" data-dictid=\"398108f4501692777191f60f958fb2\">levodopa</span> bioavailability)</li>\n<li>Dizziness</li>\n<li>Headache</li>\n<li>Sleep disturbances (e.g., insomnia)</li>\n</ul>\n<p>Psychiatric Symptoms:</p>\n<ul>\n<li>Hallucinations</li>\n<li>Confusion</li>\n<li>Increased impulsive behaviors</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Antidote for opioid poisoning is?", "options": [{"label": "A", "text": "Naloxone", "correct": true}, {"label": "B", "text": "Pethidine", "correct": false}, {"label": "C", "text": "Flumazenil", "correct": false}, {"label": "D", "text": "Physostigmine", "correct": false}], "correct_answer": "A. Naloxone", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old woman visits the clinic expressing her desire to conceive. She has a history of epilepsy and is seeking information regarding which antiepileptic medication carries the greatest risk of birth defects and is generally avoided during pregnancy.", "options": [{"label": "A", "text": "Valproate", "correct": true}, {"label": "B", "text": "Carbamazepine", "correct": false}, {"label": "C", "text": "Phenytoin", "correct": false}, {"label": "D", "text": "Lamotrigine", "correct": false}], "correct_answer": "A. Valproate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the etiology of malignant neuroleptic syndrome?", "options": [{"label": "A", "text": "Antidepressants", "correct": false}, {"label": "B", "text": "Anxiolytics", "correct": false}, {"label": "C", "text": "Antipsychotics", "correct": true}, {"label": "D", "text": "Anti-epileptics", "correct": false}], "correct_answer": "C. Antipsychotics", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the medication utilized for the treatment of refractory and intractable rheumatic chorea?", "options": [{"label": "A", "text": "Probenecid", "correct": false}, {"label": "B", "text": "Diazepam", "correct": false}, {"label": "C", "text": "Haloperidol", "correct": false}, {"label": "D", "text": "Sodium valproate", "correct": true}], "correct_answer": "D. Sodium valproate", "question_images": [], "explanation_images": [], "explanation": "\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Epileptics uses </strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Non - <span class=\"customMeta\" data-dictid=\"eb8fb619d916927771879a8048d513\">epileptic</span> uses </strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Drug of choice:</p>\n<ul>\n<li>GTCS</li>\n<li>Myoclonic and absence seizures</li>\n<li>Lennox Gastaut syndrome </li>\n<li>Dravet syndrome </li>\n<li>Juvenile Myoclonic Epilepsy</li>\n<li>Status Epilepticus (but not the choice of drug)</li>\n</ul>\n</td>\n<td>\n<ul>\n<li>Mania </li>\n<li>Bipolar disorder</li>\n<li>Rapid cyclers</li>\n<li>Migraine prophylaxis </li>\n<li>Tardive dyskinesia </li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A psychiatrist prescribes lithium for a patient who is diagnosed with bipolar disorder. Which of the following statements is incorrect regarding lithium?", "options": [{"label": "A", "text": "Lithium is teratogenic if given to pregnant females", "correct": false}, {"label": "B", "text": "Lithium toxicity is exacerbated with thiazide", "correct": false}, {"label": "C", "text": "Lithium can decrease thyroid hormone levels", "correct": false}, {"label": "D", "text": "Hemodialysis is not useful in lithium overdose", "correct": true}], "correct_answer": "D. Hemodialysis is not useful in lithium overdose", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"6ba3fb0ce51692777188eaf7843351\"&gt;Hemodialysis&lt;/span&gt; is not useful in &lt;span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\"&gt;lithium&lt;/span&gt; overdose</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Lithium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increase the level of <span class=\"customMeta\" data-dictid=\"38c81721001692777181c671bce8b3\">amine</span> (if the mood is low) by inhibiting the <span class=\"customMeta\" data-dictid=\"2e2aa646ab1692777188e3eb8286d8\">Glycogen</span> <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> kinase-3 enzyme</li>\n<li>Decrease the level of <span class=\"customMeta\" data-dictid=\"38c81721001692777181c671bce8b3\">amine</span> (if the mood is high)\n\t\t\t\t<ul>\n<li>Inhibits <span class=\"customMeta\" data-dictid=\"88151824d916927771903e5ea91ffc\">inositol</span> monophosphatase enzyme</li>\n<li>Inhibits the release of amines</li>\n<li>Stabilises neuronal membrane</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bipolar disorder</li>\n<li>Hypnic headache (occurs in sleep)</li>\n<li>Anti-suicidal action (another drug is clozapine)</li>\n<li>Resistant cases of depression</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Alopecia and acne</li>\n<li>Weight gain</li>\n<li>Seizures and <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> (leading to AV block)</li>\n<li>Hypothyroidism (hyperthyroidism in rare cases)</li>\n<li>High doses can cause <span class=\"customMeta\" data-dictid=\"28606fa66a169277718407469e7e7c\">coarse</span> tremors, ataxia, tinnitus, diarrhea, and seizures.</li>\n<li><strong>Ebstein’s anomaly: </strong>A <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> called <span class=\"customMeta\" data-dictid=\"3ab13cdf64169277720085e2ebef1c\">tricuspid</span> atresia, which has a <span class=\"customMeta\" data-dictid=\"8e016cf2891692777200f428d4b4db\">teratogenic</span> effect <strong>(Option A)</strong> when administered to pregnant women.</li>\n<li>Nephrogenic <span class=\"customMeta\" data-dictid=\"aabafbc36d16927771861d9dae54ed\">diabetes insipidus</span> (DI)</li>\n<li>Fine tremors (most common adverse effect)</li>\n<li>ECG changes: T-wave flattening</li>\n<li>Leukocytosis</li>\n<li>Loose stools (diarrhea)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs causes modulation of voltage-gated sodium channels by selectively enhancing slow inactivation?", "options": [{"label": "A", "text": "Lacosamide", "correct": true}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Lamotrigine", "correct": false}, {"label": "D", "text": "Ethosuximide", "correct": false}], "correct_answer": "A. Lacosamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-epileptic drug is commonly associated with gum hypertrophy and dizziness as side effects?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": true}, {"label": "C", "text": "Levetiracetam", "correct": false}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "B. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male presents to the emergency department with complaints of blurred vision, dizziness, and severe headache after ingesting an unknown quantity of homemade alcohol earlier in the day. On examination, he is disoriented. Laboratory tests reveal severe metabolic acidosis with a high anion gap. Which metabolite is primarily responsible for the toxicity in this case?", "options": [{"label": "A", "text": "Methanol", "correct": false}, {"label": "B", "text": "Formic acid", "correct": true}, {"label": "C", "text": "Formaldehyde", "correct": false}, {"label": "D", "text": "Acetic acid", "correct": false}], "correct_answer": "B. Formic acid", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Adulteration in Country liquor.</strong></li>\n<li>Solvent in industrial processes.</li>\n<li>Antifreeze.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Methanol ö <span class=\"customMeta\" data-dictid=\"59e3af5975169277720384661ff5bf\">Formaldehyde</span> (oxidation by alcohol dehydrogenase).</li>\n<li>Formaldehyde ö <span class=\"customMeta\" data-dictid=\"46ef53b3061692777203313130b967\">Formic acid</span> (oxidation by <span class=\"customMeta\" data-dictid=\"126202981a1692777181f2970b8c7f\">aldehyde</span> dehydrogenase).</li>\n<li>Formic Acid ö Inhibition of Cytochrome c Oxidase ö Cellular Hypoxia and <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> Acidosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features of Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CNS: <strong>Headache</strong>, dizziness, confusion, ataxia, seizures</li>\n<li>Ocular: <strong>Blurred (</strong>\"snowfield\" vision).</li>\n<li>Gastrointestinal: <strong>Nausea, vomiting</strong>,<strong> fruity breath</strong> and <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain</li>\n<li>Metabolic: <strong>Severe <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis, elevated <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> gap</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: <strong>SHAFE</strong></p>\n<ul>\n<li><strong>S</strong>odium Bicarbonate to correct <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis</li>\n<li><strong>H</strong>emodialysis to remove <span class=\"customMeta\" data-dictid=\"c578fa95fe16927771927ea57020f0\">methanol</span> and its metabolites</li>\n<li><strong>A</strong>ntidote:<strong> F</strong>omepizole or <strong>E</strong>thanol to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> ADH</li>\n<li><strong>F</strong>olinic acid or <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> to enhance <span class=\"customMeta\" data-dictid=\"8723cfd7d21692777203cc8312c239\">formate</span> metabolism.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was given an antipsychotic drug, haloperidol and the patient developed acute dystonia. Which is the next best step?", "options": [{"label": "A", "text": "Give Benztropine", "correct": true}, {"label": "B", "text": "Change to clozapine", "correct": false}, {"label": "C", "text": "Give Fluphenazine", "correct": false}, {"label": "D", "text": "Increase dose of haloperidol", "correct": false}], "correct_answer": "A. Give Benztropine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Extrapyramidal Symptoms</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute muscle <span class=\"customMeta\" data-dictid=\"61747121f116927771862fad303b93\">Dystonia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Within 1-5 days of starting antipsychotic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Administering <span class=\"customMeta\" data-dictid=\"551a84e8ff16927771811f8a7cb79b\">antiparkinsonian</span> agents such as <strong>diphenhydramine or benztropine</strong> intramuscularly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parkinsonism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Within 1 month</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benzhexol and benztropine<strong> </strong><strong>(NOT Levodopa)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Akathisia</strong></p>\n<p><strong>(Most common EPS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5–60 days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-anxiety medications</p>\n<ol>\n<li><strong>DOC: </strong><strong>Propranolol</strong> (C/I: Asthma)</li>\n<li>Diazepam</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rabbit Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Months or years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Antiparkinsonian agents.</li>\n<li><strong>Amantadine </strong>is preferred due to less adverse cognitive effects.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tardive Dyskinesia </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Late-onset adverse effects (after months or years)</p>\n<p>Occurs due to D2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"1d640454be16927771999e756dca73\">supersensitivity</span> and can be permanent, even after discontinuing <span class=\"customMeta\" data-dictid=\"4123308aeb1692777181e8820312dd\">antipsychotic</span> medication.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stop <span class=\"customMeta\" data-dictid=\"603878db1116927771812fecb63aec\">AP</span> drugs &amp; start <strong>Clozapine</strong><strong>.</strong></p>\n<p>If symptoms persist, add Dopamine depleters (VMAT2 inhibitors)</p>\n<ol>\n<li>Valbenazine</li>\n<li>Tetrabenazine: DOC for Huntington's disease.</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old obese female presented with Schizophrenia. Which of the following antipsychotic drugs causes the least weight gain?", "options": [{"label": "A", "text": "Chlorpromazine", "correct": false}, {"label": "B", "text": "Clozapine", "correct": false}, {"label": "C", "text": "Olanzapine", "correct": false}, {"label": "D", "text": "Ziprasidone", "correct": true}], "correct_answer": "D. Ziprasidone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A chronic alcoholic patient, after stopping the intake of alcohol, developed whole-body tremors along with vomiting and visual and auditory hallucinations. Which among the following is used to prevent another episode of these symptoms?", "options": [{"label": "A", "text": "Chlordiazepoxide", "correct": true}, {"label": "B", "text": "Clonidine", "correct": false}, {"label": "C", "text": "Topiramate", "correct": false}, {"label": "D", "text": "Antabuse", "correct": false}], "correct_answer": "A. Chlordiazepoxide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ch\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of Ethosuximide?", "options": [{"label": "A", "text": "Enhances GABAergic inhibition", "correct": false}, {"label": "B", "text": "Inhibits calcium channels in thalamic neurons", "correct": true}, {"label": "C", "text": "Blocks sodium channels", "correct": false}, {"label": "D", "text": "Increases serotonin levels", "correct": false}], "correct_answer": "B. Inhibits calcium channels in thalamic neurons", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ethosuximide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Primarily blocks T type of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Only used in absence seizures</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Advantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is not hepatotoxic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> suppression</li>\n<li>SLE - like symptoms</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the half-life of lithium in adults?", "options": [{"label": "A", "text": "8 hours", "correct": false}, {"label": "B", "text": "12 hours", "correct": false}, {"label": "C", "text": "24 hours", "correct": true}, {"label": "D", "text": "48 hours", "correct": false}], "correct_answer": "C. 24 hours", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pharmacokinetics of Lithium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Salt</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lithium <span class=\"customMeta\" data-dictid=\"fdae4d6e3a1692777183b5745d0c02\">carbonate</span> or citrate.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Route of administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral or IV</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Healthy adults: <strong>24 hours.</strong></li>\n<li>Young:<strong> 12 <span class=\"customMeta\" data-dictid=\"136c4bdd441692777189c5b2e976a0\">hrs</span> in the young </strong></li>\n<li>Older:<strong> 36 hours in the elderly </strong>(or longer due to a <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> GFR).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is not metabolized in the body; it remains unchanged in the system.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Excreted unchanged in all body secretions</p>\n<ul>\n<li>Maximum in the urine</li>\n<li>Sweat, <span class=\"customMeta\" data-dictid=\"6b0184a84d16927771981289924c2a\">saliva</span> and breast milk</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year male patient presents to surgery emergency with painful erection for the past 7 hours. He has a history of mood disorder and was recently prescribed medication by treating psychiatrist. Which is the likely offending drug?", "options": [{"label": "A", "text": "Mirtazapine", "correct": false}, {"label": "B", "text": "Venlafaxine", "correct": false}, {"label": "C", "text": "Trazodone", "correct": true}, {"label": "D", "text": "Tianeptine", "correct": false}], "correct_answer": "C. Trazodone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - T\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is a rare but very serious side effect of clozapine that requires regular monitoring?", "options": [{"label": "A", "text": "Agranulocytosis", "correct": true}, {"label": "B", "text": "Renal bleed", "correct": false}, {"label": "C", "text": "Hepatomegaly", "correct": false}, {"label": "D", "text": "Seizures", "correct": false}], "correct_answer": "A. Agranulocytosis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Agranulocytosis</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Serious Adverse Effects of Clozapine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Agranulocytosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rare but life-threatening decrease in white blood cells, requiring weekly monitoring.</li>\n<li>Discontinue if total <span class=\"customMeta\" data-dictid=\"00346a7f211692777191e91c2af9fc\">leukocyte</span> count &lt; 3000/mm³ or <span class=\"customMeta\" data-dictid=\"bdfd98a913169277718038aabd961f\">absolute <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> count</span> &lt; 2000/mm³.</li>\n<li><strong>Avoid combining with carbamazepine.</strong></li>\n<li>Monitoring of agranulocytosis: 1st 6 weeks - weekly; Next 6 months- Fortnightly; After 1 year- Monthly</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Seizures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dose-dependent <span class=\"customMeta\" data-dictid=\"5710e3461816927771987151d61aef\">seizure</span> risk. Higher than other <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> antipsychotics.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cardiac Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Risk of tachycardia, <span class=\"customMeta\" data-dictid=\"b37b57210716927771933ee216a834\">myocarditis</span> (fatal, within first 6 wks) and dilated cardiomyopathy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-serious Adverse effects of Clozapine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypersalivation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Known as \"wet pillow syndrome\" due to <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metabolic Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Significant risk of weight gain, hyperglycemia, and dyslipidemia.</li>\n<li>Associated with increased <span class=\"customMeta\" data-dictid=\"d4a253810c1692777181f708ba3dc6\">appetite</span> due to 5-HT2C <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockade.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cataracts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Higher risk than other <span class=\"customMeta\" data-dictid=\"06123ff61a1692777182e19b790ebc\">atypical</span> antipsychotics.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Effects on Pregnancy and Breastfeeding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Can cause decreased <span class=\"customMeta\" data-dictid=\"bf639c9a2316927771825e1632d9fb\">arousal</span> and <span class=\"customMeta\" data-dictid=\"b6a968ad961692777189ce6955627a\">hypotonia</span> in neonates.</li>\n<li>C/I during <span class=\"customMeta\" data-dictid=\"5af45ba59c16927771837f3aa7b6d9\">breastfeeding</span> due to the risk of neutropenia, sedation, and seizures in infants.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient underwent a hysterectomy and was given morphine in the post-operative period and in the ward for pain. She now presents with respiratory depression and pinpoint pupils. What is the drug used to treat this condition?", "options": [{"label": "A", "text": "Naloxone", "correct": true}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Phentolamine", "correct": false}, {"label": "D", "text": "Physostigmine", "correct": false}], "correct_answer": "A. Naloxone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Naloxone</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Opioid Overdose/ Poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Clinical, accidental, or suicidal overdose.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Unconsiousness/coma</li>\n<li>Miosis: Pin point pupil</li>\n<li>Respiratory depression</li>\n<li>Dry <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in the eye/mouth</li>\n<li>Urinary retention</li>\n<li>Constipation</li>\n<li>Flaccid muscles</li>\n<li>Convulsions (in children)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Acute overdose/poisoning:</strong> IV Naloxone (Antidote) → <strong>Maintenance</strong> (Detoxification phase: To prevent withdrawal):</p>\n<ul>\n<li>Opioids: Buprenorphine, Methadone, Tramadol</li>\n<li>Non-Opioids- Clonidine, Lofexidine → <strong>Abstinence</strong> (Prevent relapse):</li>\n<li>DOC: Oral Naltrexone</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs can be used in diabetic neuropathy, post herpetic neuralgia and spinal cord injury?", "options": [{"label": "A", "text": "Amitriptyline", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Pregabalin", "correct": true}], "correct_answer": "D. Pregabalin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/7gtYojviiZdYCiHVSGCa1745994255.png"], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"95bd9f167816927771962343383432\"&gt;Pregabalin&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Sodium valproate has an inhibitory action at which of the following sites?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://image.prepladder.com/notes/PohAlOiEcrrF2rBHmR0z1746181975.png"], "explanation_images": ["https://image.prepladder.com/notes/1B2IPsZi6tFpZJd3hbhZ1746182048.png"], "explanation": "<p>Correct Answer B - B</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sodium Valproate </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Sodium Channel Inactivation</strong>: Prolongs Na+ channel <span class=\"customMeta\" data-dictid=\"2f7bf58a321692777190e32a914615\">inactivation</span> in a frequency-dependent manner, similar to phenytoin.</li>\n<li><strong>Calcium Channel Modulatio</strong>n: Weakly attenuates the T-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> currents, akin to ethosuximide.</li>\n<li><strong>GABA Enhancement</strong>: Increases <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> levels by:\n\t\t\t\t<ul>\n<li>Inhibiting <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> transaminase, leading to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> degradation.</li>\n<li>Possibly enhancing <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> from glutamic acid.</li>\n</ul>\n</li>\n<li><strong>Glutamate <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Blockade</strong>: Blocks <span class=\"customMeta\" data-dictid=\"082e153b9316927771872bec02a55d\">excitatory</span> <span class=\"customMeta\" data-dictid=\"000b76a37716927771932ba41c5089\">NMDA</span> <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptors, reducing <span class=\"customMeta\" data-dictid=\"082e153b9316927771872bec02a55d\">excitatory</span> neurotransmission.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Seizure Disorders:</strong> It is the <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for <strong>atypical absence seizures, myoclonic seizures, </strong>and <strong>generalised <span class=\"customMeta\" data-dictid=\"a4156d43e216927772008460f9b582\">tonic-clonic</span> seizures (GTCS).</strong></li>\n<li><strong>Mood Disorders:</strong> Valproate is effective in the treatment of <span class=\"customMeta\" data-dictid=\"51c142d5d116927771912526695796\">mania</span> and <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder.</li>\n<li><strong>Panic Attacks:</strong> It can be used off-label for the treatment of panic attacks.</li>\n<li><strong>Migraine Prophylaxis:</strong> Valproate is considered a second-line treatment for preventing migraines.</li>\n<li><strong>Mixed <span class=\"customMeta\" data-dictid=\"5710e3461816927771987151d61aef\">Seizure</span> Syndromes:</strong> It is used in conditions such as <strong>Lennox-Gastaut syndrome.</strong></li>\n<li><strong>Severe Myoclonic <span class=\"customMeta\" data-dictid=\"7546d26cea1692777187c257d4e14c\">Epilepsy</span> of Infancy: </strong>Valproate is also used in <strong>Dravet syndrome.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Gastrointestinal: </strong>Nausea, vomiting, and indigestion.</li>\n<li><strong>Neurological:</strong> Tremor, sedation, dizziness, and ataxia.</li>\n<li><strong>Hepatic: <span class=\"customMeta\" data-dictid=\"cbc7c810ce1692777188e6eaf3eba2\">Hepatotoxicity</span> (mainly in children &lt;2 years of age).</strong></li>\n<li><strong>Hematologic:</strong> <strong>Thrombocytopenia</strong> and other blood dyscrasias.</li>\n<li><strong>Metabolic: </strong>Weight gain, hyperammonemia, and pancreatitis.</li>\n<li><strong>Teratogenicity: </strong>Risk of <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> malformations, such as <strong>neural tube defects (spina bifida oculta),</strong> if used during pregnancy.</li>\n<li><strong>Others: </strong>Hair loss (alopecia) and <strong>polycystic <span class=\"customMeta\" data-dictid=\"7b1a7ff355169277719401475de6fb\">ovary</span> syndrome (PCOS).</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Valproate is a CYP <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> that <strong>inhibits CYP2C9</strong>, which can lead to increased levels of drugs metabolised by this enzyme, such as <span class=\"customMeta\" data-dictid=\"edf54937821692777195e3eec4e676\">phenytoin</span> and warfarin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on fluoxetine was started on a pain control drug for neurotic pain. He developed an episode of syncope after 2 weeks. ECG reveals a QT interval of 477ms. Which of the following is the causative drug?", "options": [{"label": "A", "text": "Methadone", "correct": true}, {"label": "B", "text": "Morphine", "correct": false}, {"label": "C", "text": "Meperidine", "correct": false}, {"label": "D", "text": "Propoxyphene", "correct": false}], "correct_answer": "A. Methadone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Meth\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a new drug approved for Rett syndrome is?", "options": [{"label": "A", "text": "Trofinetide", "correct": true}, {"label": "B", "text": "Folinic acid", "correct": false}, {"label": "C", "text": "L-carnitine", "correct": false}, {"label": "D", "text": "Naltrexone", "correct": false}], "correct_answer": "A. Trofinetide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the appropriate antidote for Benzodiazepine overdose?", "options": [{"label": "A", "text": "Flumazenil", "correct": true}, {"label": "B", "text": "Flurazepam", "correct": false}, {"label": "C", "text": "Barbiturates", "correct": false}, {"label": "D", "text": "Buspirone", "correct": false}], "correct_answer": "A. Flumazenil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"3ad8a42ad216927772024759d8ec38\"&gt;Flumazenil&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following adverse effects is more commonly associated with oxcarbazepine than with carbamazepine?", "options": [{"label": "A", "text": "Hepatotoxicity", "correct": false}, {"label": "B", "text": "Stevens-Johnson syndrome", "correct": false}, {"label": "C", "text": "Thrombocytopenia", "correct": false}, {"label": "D", "text": "Dilutional hyponatremia", "correct": true}], "correct_answer": "D. Dilutional hyponatremia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true about lithium?", "options": [{"label": "A", "text": "It can cause fine tremors in the therapeutic range", "correct": true}, {"label": "B", "text": "It is not absorbed in the stomach", "correct": false}, {"label": "C", "text": "Approved for absence seizure", "correct": false}, {"label": "D", "text": "Lithium is not teratogenic", "correct": false}], "correct_answer": "A. It can cause fine tremors in the therapeutic range", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following mood stabilizers causes hepatotoxicity and hyperammonemia?", "options": [{"label": "A", "text": "Lithium", "correct": false}, {"label": "B", "text": "Valproate", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "B. Valproate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - V\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child is brought to the clinic with a fever and has been experiencing continuous seizures for the last 30 minutes. The caregivers report no seizure-free intervals during this time. What is the most appropriate immediate action to manage this patient?", "options": [{"label": "A", "text": "Manage the fever and wait for seizure to subside", "correct": false}, {"label": "B", "text": "Give midazolam immediately", "correct": true}, {"label": "C", "text": "Give clobazam immediately", "correct": false}, {"label": "D", "text": "Manage the airway and wait for seizure to subside", "correct": false}], "correct_answer": "B. Give midazolam immediately", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Give &lt;span class=\"customMeta\" data-dictid=\"a2e652a5261692777192d6890d6cf4\"&gt;midazolam&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "After undergoing lithium therapy for a year, all of the following adverse effects are visible, except:", "options": [{"label": "A", "text": "Hypothyroidism", "correct": false}, {"label": "B", "text": "Tremors", "correct": false}, {"label": "C", "text": "Diabetes insipidus", "correct": false}, {"label": "D", "text": "Tardive dyskinesia", "correct": true}], "correct_answer": "D. Tardive dyskinesia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"d93ab38f5316927772001828e5e817\"&gt;Tardive&lt;/span&gt; dysk\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not classified as a selective serotonin reuptake inhibitor (SSRI) used in the treatment of depression?", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Sertraline", "correct": false}, {"label": "C", "text": "Trazadone", "correct": true}, {"label": "D", "text": "Escitalopram", "correct": false}], "correct_answer": "C. Trazadone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - T\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the management of CMV retinitis, which drug is considered the drug of choice?", "options": [{"label": "A", "text": "Cotrimoxazole", "correct": false}, {"label": "B", "text": "Valacyclovir", "correct": false}, {"label": "C", "text": "Tenofovir", "correct": false}, {"label": "D", "text": "Ganciclovir", "correct": true}], "correct_answer": "D. Ganciclovir", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the case of a newborn delivered by an HIV-positive woman who was not receiving treatment, what is the recommended initial course of treatment to reduce the risk of mother-to-child transmission of HIV?", "options": [{"label": "A", "text": "Nevirapine 6 months", "correct": false}, {"label": "B", "text": "Zidovudine 6 weeks", "correct": false}, {"label": "C", "text": "Nevirapine + Zidovudine + Lamivudine6 weeks", "correct": true}, {"label": "D", "text": "Nevirapine 6 weeks", "correct": false}], "correct_answer": "C. Nevirapine + Zidovudine + Lamivudine6 weeks", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"5b737ea2b4169277719338ba5f0a07\"&gt;Nevirapine&lt;/span&gt; + &lt;span class=\"customMeta\" data-dictid=\"929423b7711692777202c3adc5f32c\"&gt;Zidovudine&lt;/span&gt; + &lt;span class=\"customMeta\" data-dictid=\"548c02a1cf1692777191e70df694f8\"&gt;Lamivudine&lt;/span&gt; 6 week\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred drug for the treatment of facial nerve palsy?", "options": [{"label": "A", "text": "Acyclovir", "correct": false}, {"label": "B", "text": "Ceftriaxone", "correct": false}, {"label": "C", "text": "Prednisolone", "correct": true}, {"label": "D", "text": "Naproxen", "correct": false}], "correct_answer": "C. Prednisolone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - P\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the appropriate antidote for Benzodiazepine overdose?", "options": [{"label": "A", "text": "Flumazenil", "correct": true}, {"label": "B", "text": "Flurazepam", "correct": false}, {"label": "C", "text": "Barbiturates", "correct": false}, {"label": "D", "text": "Buspirone", "correct": false}], "correct_answer": "A. Flumazenil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Flu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An elderly patient with dementia is not compliant with oral medications. Which of the following will be beneficial in this case?", "options": [{"label": "A", "text": "Donepezil", "correct": false}, {"label": "B", "text": "Rivastigmine", "correct": true}, {"label": "C", "text": "Galantamine", "correct": false}, {"label": "D", "text": "Memantine", "correct": false}], "correct_answer": "B. Rivastigmine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Rivastig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on amitriptyline was found in an unconscious state. Which of the following does not suggest amitriptyline toxicity?", "options": [{"label": "A", "text": "Arrhythmias", "correct": false}, {"label": "B", "text": "Confusion", "correct": false}, {"label": "C", "text": "Hypothermia", "correct": true}, {"label": "D", "text": "Mydriasis", "correct": false}], "correct_answer": "C. Hypothermia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Hypothermia</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of side effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>H1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Sedation, weight gain</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anticholinergic action on <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hyperthermia <strong>(Option C) </strong></li>\n<li>Dry eyes/mouth</li>\n<li>Mydriasis (C/I in glaucoma) <strong>(Option D) </strong></li>\n<li>Urinary retention</li>\n<li>Constipation</li>\n<li>Tachycardia</li>\n<li>Confusion <strong>(Option B) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Increase in <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> in the brain</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Seizure threshold reduction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha 1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Postural hypotension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sodium channel block</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Arrhythmia/QT prolongation <strong>(Option A) </strong></li>\n<li>Bradycardia in <span class=\"customMeta\" data-dictid=\"40b788dd6916927771888a3ea6872f\">heart block</span> due to overdose</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following recently approved medication is used to treat amyotrophic lateral sclerosis ?", "options": [{"label": "A", "text": "Edaravone", "correct": true}, {"label": "B", "text": "Piracetam", "correct": false}, {"label": "C", "text": "Dabrafenib", "correct": false}, {"label": "D", "text": "Trametinib", "correct": false}], "correct_answer": "A. Edaravone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Edarav\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented to the casualty with signs of dehydration due to severe vomiting . The intern gave the patient a parenteral medication, following which the patient developed grimacing and abnormal posturing . What could have been the inciting drug of this reaction?", "options": [{"label": "A", "text": "Atropine", "correct": false}, {"label": "B", "text": "Ranitidine", "correct": false}, {"label": "C", "text": "Metoclopramide", "correct": true}, {"label": "D", "text": "Domperidone", "correct": false}], "correct_answer": "C. Metoclopramide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - M\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A bank employee suffering from depression came to AIIMS OPD . He was started on Escitalopram . Which of these adverse effects cannot be explained with escitalopram?", "options": [{"label": "A", "text": "Sialorrhea", "correct": true}, {"label": "B", "text": "Vivid dreams", "correct": false}, {"label": "C", "text": "Anorgasmia", "correct": false}, {"label": "D", "text": "Nausea", "correct": false}], "correct_answer": "A. Sialorrhea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Sialorrh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Z track technique is used for?", "options": [{"label": "A", "text": "Administration of nicotine patches", "correct": false}, {"label": "B", "text": "Monitoring of carbamazepine therapy", "correct": false}, {"label": "C", "text": "Administration of long acting depot antipsychotics", "correct": true}, {"label": "D", "text": "Monitoring of lithium therapy", "correct": false}], "correct_answer": "C. Administration of long acting depot antipsychotics", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Administration of long-acting &lt;span class=\"customMeta\" data-dictid=\"25116121ed169277718644b8fe30ff\"&gt;depot&lt;/span&gt; antipsychotics: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common side effect of Lamotrigine ?", "options": [{"label": "A", "text": "Diplopia", "correct": false}, {"label": "B", "text": "Tremors", "correct": false}, {"label": "C", "text": "Neutropenia", "correct": false}, {"label": "D", "text": "Rash", "correct": true}], "correct_answer": "D. Rash", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Rash\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug class</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Antiepileptic</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td>\n<p>Voltage-gated <span class=\"customMeta\" data-dictid=\"276be2047116927771989f7bf5ed02\">sodium channel</span> blocker</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Indications</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Partial seizures, generalized seizures, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder</p>\n</li>\n<li>\n<p>DOC for <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> seizures elderly</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Dosage forms</strong></p>\n</td>\n<td>\n<p>Tablets, chewable tablets, orally disintegrating tablets</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Dosage</strong></p>\n</td>\n<td>\n<p>Varies depending on the condition being treated and other factors; usually started at a low dose and gradually increased over several weeks</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Common side effects</strong></p>\n</td>\n<td>\n<p>Rash, headache, nausea, dizziness, blurred vision</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Serious side effects</strong></p>\n</td>\n<td>\n<ul>\n<li>\n<p>Steven Johnson Syndrome (skin surface &lt;30%)</p>\n</li>\n<li>\n<p>Toxic <span class=\"customMeta\" data-dictid=\"616d85c57416927771875ef23f6751\">Epidermal</span> <span class=\"customMeta\" data-dictid=\"254d4c2ea21692777193838ccf204d\">Necrolysis</span> (skin surface &gt;30%)</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Among the subsequent atypical antipsychotic medications, which one poses the greatest likelihood of galactorrhea?", "options": [{"label": "A", "text": "Iloperidone", "correct": false}, {"label": "B", "text": "Risperidone", "correct": true}, {"label": "C", "text": "Clozapine", "correct": false}, {"label": "D", "text": "Aripiprazole", "correct": false}], "correct_answer": "B. Risperidone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - R\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Antidote for alprazolam is:", "options": [{"label": "A", "text": "Protamine sulphate", "correct": false}, {"label": "B", "text": "Flumazenil", "correct": true}, {"label": "C", "text": "EDTA", "correct": false}, {"label": "D", "text": "BAL", "correct": false}], "correct_answer": "B. Flumazenil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Flu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Secretion of prolactin is inhibited by ?", "options": [{"label": "A", "text": "Dopamine", "correct": true}, {"label": "B", "text": "Nor-adrenaline", "correct": false}, {"label": "C", "text": "Adrenaline", "correct": false}, {"label": "D", "text": "Serotonin", "correct": false}], "correct_answer": "A. Dopamine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Anti-depressant drug which is used for smoking cessation is ?", "options": [{"label": "A", "text": "Venlafaxine", "correct": false}, {"label": "B", "text": "Topiramate", "correct": false}, {"label": "C", "text": "Bupropion", "correct": true}, {"label": "D", "text": "Amitriptyline", "correct": false}], "correct_answer": "C. Bupropion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Bupropion: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male presents with symptoms of decreased sleep, increased activity levels, and an elevated mood. He also has a family history of manic episodes. Which of the following treatments is most appropriate for his condition?", "options": [{"label": "A", "text": "Fluoxetine", "correct": false}, {"label": "B", "text": "Lithium", "correct": true}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Lamotrigine", "correct": false}], "correct_answer": "B. Lithium", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Lithiu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is used as an antidote in opioid overdose?", "options": [{"label": "A", "text": "Naloxone", "correct": true}, {"label": "B", "text": "Flumazenil", "correct": false}, {"label": "C", "text": "Fomepizole", "correct": false}, {"label": "D", "text": "Pethidine", "correct": false}], "correct_answer": "A. Naloxone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct option A: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-epileptic drug is least teratogenic during pregnancy?", "options": [{"label": "A", "text": "Phenytoin", "correct": false}, {"label": "B", "text": "Valproate", "correct": false}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Levetiracetam", "correct": true}], "correct_answer": "D. Levetiracetam", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/y6wcIkytcoPtolVR5g061713435453.png"], "explanation": "<p>Correct option D: Lev\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which antiepileptic drug has the lowest risk of causing birth defects during pregnancy?", "options": [{"label": "A", "text": "Valproate", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Carbamazepine", "correct": false}, {"label": "D", "text": "Levetiracetam", "correct": true}], "correct_answer": "D. Levetiracetam", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Lev\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-amoebic medication, when combined with alcohol, may have caused the lady to experience symptoms such as nausea, vomiting, and dizziness at a social gathering?", "options": [{"label": "A", "text": "Metronidazole", "correct": true}, {"label": "B", "text": "Nitazoxanide", "correct": false}, {"label": "C", "text": "Paromomycin", "correct": false}, {"label": "D", "text": "Diloxanide", "correct": false}], "correct_answer": "A. Metronidazole", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - M\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td style=\"text-align:center\"><strong>Drug </strong></td>\n<td style=\"text-align:center\"><strong>Drug Class</strong></td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Metronidazole</td>\n<td style=\"text-align:center\">Nitroimidazole </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Cefotetan </td>\n<td style=\"text-align:center\">Cephalosporin </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Tinidazole </td>\n<td style=\"text-align:center\">Nitroimidazole </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Griseofulvin </td>\n<td style=\"text-align:center\">Antifungal </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Procarbazine </td>\n<td style=\"text-align:center\">Antineoplastic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Certain Sulfonylurea</td>\n<td style=\"text-align:center\">Antidiabetic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Drugs (e.g., tolbutamide)</td>\n<td style=\"text-align:center\"> </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Certain cephalosporins </td>\n<td style=\"text-align:center\">Cephalosporin </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">(E.g., cefoperazone, cefamandole)</td>\n<td style=\"text-align:center\"> </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Chlorpropamide</td>\n<td style=\"text-align:center\">Antidiabetic</td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Disulfiram </td>\n<td style=\"text-align:center\">Alcohol Deterrent </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Chlorpromazine acts on which of the following receptor? 1) D2 and 5-HT2 receptor 2) GABA and beta - adrenergic receptor 3) Muscarinic M1 and alpha - adrenergic receptors 4) H1 receptors", "options": [{"label": "A", "text": "1, 3 and 4 are correct", "correct": true}, {"label": "B", "text": "Only 2 is correct", "correct": false}, {"label": "C", "text": "1 and 2 are correct", "correct": false}, {"label": "D", "text": "All are correct", "correct": false}], "correct_answer": "A. 1, 3 and 4 are correct", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - 1, 3 and 4\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Benzodiazepines have a wider therapeutic index compared to barbiturates.", "question_images": ["https://image.prepladder.com/content/RseIBh36rToJYR4pMTft1736826779.png"], "explanation_images": ["https://image.prepladder.com/content/ctgX5sSj1vJkx8mfQvXM1736826911.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AUXL5Ue6pR5v09CzJF641748805663.mp3", "video": ""}, {"text": "Which of the following statements regarding GABA receptors is incorrect? GABA-A receptors are dimeric metabotropic receptors and mediate inhibitory neurotransmission. GABA-B receptors are inhibitory G protein-coupled receptors and mediate slow inhibitory neurotransmission through the efflux of potassium. Activation of GABA-A receptors results in the efflux of chloride ions into the neuron. α and γ subunits of GABA-A receptors modulate drug efficacy. GABA-C receptors are structurally and functionally similar to GABA-A receptors", "options": [{"label": "A", "text": "1 and 3", "correct": true}, {"label": "B", "text": "1, 3 and 5", "correct": false}, {"label": "C", "text": "3 and 5", "correct": false}, {"label": "D", "text": "2, 3 and 5", "correct": false}], "correct_answer": "A. 1 and 3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:695px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GABA A</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Pentameric ionotropic ligand-gated Cl– channels </strong></li>\n<li>5 Subunits: 2 α, 2 <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> and 1 γ</li>\n<li>α and γ subunits affect the <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> of <span class=\"customMeta\" data-dictid=\"020ca042e51692777182e5ffb60944\">benzodiazepine</span> binding and channel modulation</li>\n<li>Fast <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> <span class=\"customMeta\" data-dictid=\"66748a30e91692777193358c35b2b0\">neurotransmission</span> through hyperpolarisation of the neurons by Cl- <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> influx</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Benzodiazepines (diazepam etc.)</p>\n<ul>\n<li>Acts as a positive allosteric modulator</li>\n<li>Increase the frequency of opening of the GABA-A receptor.</li>\n</ul>\n<p>2. Barbiturates</p>\n<ul>\n<li>Binds at multiple sites</li>\n<li>Increase mean open time with no effect on frequency.</li>\n</ul>\n<p>3. <span class=\"customMeta\" data-dictid=\"656e217bb81692777202d82810ba2a\">Volatile</span> anaesthetics</p>\n<p>4. Brexanolone (neuroactive steroid)</p>\n<p>5. Ethanol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GABA B</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Metabotropic <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> G protein-coupled receptor</strong></li>\n<li>Heterodimers with 2 subunits</li>\n<li>Gi type of GPCR</li>\n<li>Inhibit <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> cyclase, <span class=\"customMeta\" data-dictid=\"dddc752e1716927771807f985bb8bb\">activate</span> K+ channels (K+ efflux), and reduce Ca2+ conductance</li>\n<li><strong>Slow <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> neurotransmission</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"56520cf18e16927771824d7f822508\">Baclofen</span> (muscle relaxant)</p>\n<p>2. gamma-hydroxybutyric acid ( narcolepsy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GABA C</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ionotropic receptor</li>\n<li><strong>Structurally and functionally similar to <span class=\"customMeta\" data-dictid=\"7261f495801692777187bd2837e9f9\">GABA</span> A receptors.</strong></li>\n<li>Location: Retina</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/00ns0JJytpb6D4ONBg8P1748805923.mp3", "video": ""}, {"text": "Arrange the following barbiturates based on their duration of action from shortest to longest: Secobarbital Phenobarbital Thiopental Pentobarbital", "options": [{"label": "A", "text": "3, 1, 4, 2", "correct": true}, {"label": "B", "text": "2, 1, 3, 4", "correct": false}, {"label": "C", "text": "1, 2, 4, 3", "correct": false}, {"label": "D", "text": "2, 1, 3, 4", "correct": false}], "correct_answer": "A. 3, 1, 4, 2", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ultra short-acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-15 mins</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Redistribution into fats</p>\n<ol>\n<li><strong>Thiopentone</strong>: Sodium pentothal\n\n\t\t\t\t<ul>\n<li>Uses: general anesthesia, narcoanalysis</li>\n<li>Side effect: Acute <span class=\"customMeta\" data-dictid=\"8502a8f15e16927771909160b28bf2\">intermittent</span> porphyria, <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> with arterial injection</li>\n</ul>\n</li>\n<li>Methohexitone:\n\t\t\t\t<ul>\n<li>Use: DOC in Electroconvulsive therapy</li>\n</ul>\n</li>\n<li>Propofol</li>\n<li>Etomidate</li>\n<li>Ketamine</li>\n<li>Fentanyl (Opioid)</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Short-acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3-8 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs <span class=\"customMeta\" data-dictid=\"7ae760ae1b169277718794068316b8\">ending</span> with -barbitone or -barbital</p>\n<ol>\n<li>Butobarbitone</li>\n<li>Amobarbitone</li>\n<li><strong>Secobarbital</strong></li>\n<li><strong>Pentobarbitone</strong></li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Long-acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Days</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Phenobarbitone</strong> (Phenobarbital)</li>\n<li>Primidone: Used in essential tremors</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ncxoYryKyRg7KPT9PtO01748806045.mp3", "video": ""}, {"text": "A 42-year-old male with treatment-resistant major depressive disorder is scheduled for electroconvulsive therapy (ECT). The anesthesiologist plans to use a rapid-onset medication to minimize the side effects and facilitate quick recovery. Which of the following is the drug of choice for this patient?", "options": [{"label": "A", "text": "Thiopental", "correct": false}, {"label": "B", "text": "Propofol", "correct": false}, {"label": "C", "text": "Methohexital", "correct": true}, {"label": "D", "text": "Midazolam", "correct": false}], "correct_answer": "C. Methohexital", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pWDAuSCbtt6kw2DCjh9T1748806182.mp3", "video": ""}, {"text": "A 2-day-old neonate is brought to the hospital with abnormal jerking movements in arms and legs. On examination, electroencephalogram (EEG) recording revealed abnormal electrical activity in the brain. What is the drug of choice for managing this patient condition?", "options": [{"label": "A", "text": "Phenobarbital", "correct": true}, {"label": "B", "text": "Phenytoin", "correct": false}, {"label": "C", "text": "Levetiracetam", "correct": false}, {"label": "D", "text": "Midazolam", "correct": false}], "correct_answer": "A. Phenobarbital", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:705px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phenobarbital (Phenobarbitone)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">Neonatal</span> seizures</li>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">Neonatal</span> jaundice: Crigler Najjar syndrome type 2</li>\n<li>DOC in Gilbert syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase GABA-A <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> Cl<sup>-</sup> channel opening duration without affecting the frequency.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CYP3A4 <span class=\"customMeta\" data-dictid=\"25e7f7c2fe16927771901cfeae09b1\">Inducer</span> (induces UDP-GT activity in Gilbert syndrome)</li>\n<li>pH-dependent <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> excretion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Paradoxical excitation: Seen in children</li>\n<li>Hyperkinesia</li>\n<li>Excessive sensation and pain perception</li>\n<li>Rapid metabolisation of oral contraceptives</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"8502a8f15e16927771909160b28bf2\">intermittent</span> <span class=\"customMeta\" data-dictid=\"e5f770f89c16927771966b9e3da618\">porphyria</span> (CYP <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> inducers increase <span class=\"customMeta\" data-dictid=\"d4fff554a316927771885dc8700abe\">heme</span> demand)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/m0hYGOJ8AVUtAnmypyOI1748806294.mp3", "video": ""}, {"text": "A 25-year-old student with a past history of suicide is brought to the emergency by his roommate, who found him unresponsive with an empty bottle of unknown pills. On examination, the patient is comatose with shallow breathing, hypotension, and decreased reflexes with mild pupillary dilatation. What is the most appropriate treatment for this patient's condition?", "options": [{"label": "A", "text": "Hemodialysis", "correct": false}, {"label": "B", "text": "Sodium bicarbonate", "correct": true}, {"label": "C", "text": "Flumazenil", "correct": false}, {"label": "D", "text": "Naloxone", "correct": false}], "correct_answer": "B. Sodium bicarbonate", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:486px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CNS depression, coma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Airway protection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypotension</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IV fluids, vasopressors if needed</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>QRS widening, arrhythmias (on ECG)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IV sodium bicarbonate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seizures</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benzodiazepines</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/b01Py8x9guhabpdvuGo71748806428.mp3", "video": ""}, {"text": "Duration of action of which of the following benzodiazepines is determined by its rate of biotransformation?", "options": [{"label": "A", "text": "Lorazepam", "correct": true}, {"label": "B", "text": "Flurazepam", "correct": false}, {"label": "C", "text": "Diazepam", "correct": false}, {"label": "D", "text": "Clonazepam", "correct": false}], "correct_answer": "A. Lorazepam", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:655px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CLASS A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CLASS B</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs in this class need to be converted into their active metabolites</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs in this class are in their active forms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Active metabolites are biotransformed slower than parent drugs - duration of action of drugs has little to no relationship with rate of <span class=\"customMeta\" data-dictid=\"544ff0d1ca16927771838eac3d5051\">biotransformation</span> of parent drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Duration of action is determined by the rate of <span class=\"customMeta\" data-dictid=\"544ff0d1ca16927771838eac3d5051\">biotransformation</span> of the drug itself</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All benzodiazepines except those in class B</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lorazepam</li>\n<li>Oxazepam</li>\n<li>Temazepam</li>\n<li>Triazolam</li>\n<li>Midazolam</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gIZx77igYh6cbFHHQIsM1749048835.mp3", "video": ""}, {"text": "A patient presents with a history of rigorous movements of the body associated with uprolling of eyes and wetting. Which of the following drugs will most likely not be suitable for this patient?", "options": [{"label": "A", "text": "Clonazepam", "correct": false}, {"label": "B", "text": "Flurazepam", "correct": true}, {"label": "C", "text": "Midazolam", "correct": false}, {"label": "D", "text": "Lorazepam", "correct": false}], "correct_answer": "B. Flurazepam", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:638px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Seizure control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clobazam</li>\n<li><strong>Clonazepam</strong></li>\n<li><strong>Clorazepate</strong></li>\n<li>Diazepam</li>\n<li><strong>Lorazepam</strong></li>\n<li>Midazolam</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pre-anaesthesia &amp; anaesthesia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diazepam</li>\n<li><strong>Lorazepam</strong></li>\n<li>Midazolam</li>\n<li>Remimazolam</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Status epilepticus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diazepam</li>\n<li><strong>Lorazepam</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcohol withdrawal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chlordiazepoxide</li>\n<li><strong>Clorazepate</strong></li>\n<li>Diazepam</li>\n<li><strong>Lorazepam</strong></li>\n<li>Midazolam</li>\n<li>Oxazepam</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Muscle relaxation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diazepam</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Insomnia</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Estazolam</li>\n<li>Flurazepam</li>\n<li>Quazepam</li>\n<li>Temazepam</li>\n<li>Triazolam</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mood disorders (anxiety, mania)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Alprazolam</li>\n<li>Chlordiazepoxide</li>\n<li>Clobazam</li>\n<li><strong>Clonazepam</strong></li>\n<li><strong>Clorazepate</strong></li>\n<li>Diazepam</li>\n<li><strong>Lorazepam</strong></li>\n<li>Midazolam</li>\n<li>Oxazepam</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vmAGDEkCY758Tw9O5EcG1748806747.mp3", "video": ""}, {"text": "Which of the following drugs selectively helps improve insomnia without muscle relaxation?", "options": [{"label": "A", "text": "Clobazam", "correct": false}, {"label": "B", "text": "Zopiclone", "correct": true}, {"label": "C", "text": "Flurazepam", "correct": false}, {"label": "D", "text": "Carisoprodol", "correct": false}], "correct_answer": "B. Zopiclone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hIWxnygveMUGSI3IiujC1748806858.mp3", "video": ""}, {"text": "A 45-year-old blind patient presents with difficulty falling asleep and maintaining sleep. The patient reports a history of insomnia that has persisted despite trying various lifestyle modifications. Which of the following drugs is approved for the treatment of this condition?", "options": [{"label": "A", "text": "Tasimelteon", "correct": true}, {"label": "B", "text": "Zolpidem", "correct": false}, {"label": "C", "text": "Etizolam", "correct": false}, {"label": "D", "text": "Lorazepam", "correct": false}], "correct_answer": "A. Tasimelteon", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-24-hour Sleep-Wake Disorder</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This disorder occurs predominantly in <strong>blind individuals</strong> due to the lack of light perception, which helps to regulate the body’s natural <span class=\"customMeta\" data-dictid=\"6d2d14b32a1692777184597558c86a\">circadian</span> rhythm. Without light cues, the individual’s sleep-wake cycle becomes unaligned with the 24-hour day, leading to <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> sleep patterns.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common symptoms include <strong>difficulty falling asleep</strong>, <strong>maintaining sleep</strong>, and <strong>daytime sleepiness</strong>. The symptoms worsen as the person’s sleep-wake cycle shifts, typically becoming progressively worse each day.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment with Tasimelteon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tasimelteon</strong> works by <strong>mimicking the action of melatonin</strong> at its receptors, specifically the <strong>MT1 and MT2 receptors</strong>, which help regulate the sleep-wake cycle. It is FDA-approved for <strong>blind patients</strong> with <strong>Non-24-hour sleep-wake disorder</strong> to improve sleep onset and maintenance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Administration and Effectiveness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tasimelteon is usually administered <strong>at bedtime</strong> and has shown <strong>effectiveness</strong> in improving both <strong>sleep onset</strong> and <strong>sleep duration</strong> in patients with Non-24. It aligns the individual’s <span class=\"customMeta\" data-dictid=\"6d2d14b32a1692777184597558c86a\">circadian</span> rhythm with the 24-hour day cycle.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ramelteon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MT1 &amp; MT2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Insomnia (night shift workers, jet lag)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolized by <strong>CYP1A, CYP2C, and CYP3A4</strong>; <strong>high first-pass metabolism</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tasimelteon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MT1 &amp; MT2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-24-hour sleep-wake disorder (blind individuals), Smith-Magenis syndrome (night-time disturbances)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolized by <strong>CYP1A2</strong> and <strong>CYP3A4</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/II1KLq8ydLVCZErjdVQd1747296964.mp3", "video": ""}, {"text": "A patient with sleep disturbances is prescribed suvorexant. How does this drug help in improving insomnia?", "options": [{"label": "A", "text": "Inhibiting H1 histamine receptors", "correct": false}, {"label": "B", "text": "Serotonergic 5HT2A/2C antagonism", "correct": false}, {"label": "C", "text": "Orexin receptor antagonism", "correct": true}, {"label": "D", "text": "Inhibiting serotonergic 5HT2C receptor alone", "correct": false}], "correct_answer": "C. Orexin receptor antagonism", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/omjLtHIiQWnWTuqayU6R1748806969.mp3", "video": ""}, {"text": "A 35-year-old male presents with severe headache, nausea, vomiting, blurred vision, disorientation, and fruity breath odour after consuming homemade liquor 12 hours ago. Blood gas analysis shows pH 7.25, bicarbonate 12 mmol/L, and anion gap metabolic acidosis. What is the drug of choice for his condition?", "options": [{"label": "A", "text": "N-acetylcysteine", "correct": false}, {"label": "B", "text": "Fomepizole", "correct": true}, {"label": "C", "text": "Atropine", "correct": false}, {"label": "D", "text": "Naloxone", "correct": false}], "correct_answer": "B. Fomepizole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Adulteration in Country liquor.</strong></li>\n<li>Solvent in industrial processes.</li>\n<li>Antifreeze.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Methanol ⟶ <span class=\"customMeta\" data-dictid=\"59e3af5975169277720384661ff5bf\">Formaldehyde</span> (oxidation by alcohol dehydrogenase).</li>\n<li>Formaldehyde ⟶ <span class=\"customMeta\" data-dictid=\"46ef53b3061692777203313130b967\">Formic acid</span> (oxidation by <span class=\"customMeta\" data-dictid=\"126202981a1692777181f2970b8c7f\">aldehyde</span> dehydrogenase).</li>\n<li>Formic Acid ⟶ <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of <span class=\"customMeta\" data-dictid=\"29e8e2a5dd16927771855db589c581\">Cytochrome</span> c <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">Oxidase</span> ⟶ <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">Cellular</span> <span class=\"customMeta\" data-dictid=\"a249eeb5551692777189661d39c1b2\">Hypoxia</span> and <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> Acidosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features of Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CNS: <strong>Headache</strong>, dizziness, confusion, ataxia, seizures</li>\n<li>Ocular: <strong>Blurred (</strong>\"snowfield\" vision).</li>\n<li>Gastrointestinal: <strong>Nausea, vomiting</strong>,<strong> fruity breath</strong> and <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain</li>\n<li>Metabolic: <strong>Severe <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis, elevated <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> gap</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: <strong>SHAFE</strong></p>\n<ul>\n<li><strong>S</strong>odium <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">Bicarbonate</span> to correct <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> acidosis</li>\n<li><strong>H</strong>emodialysis to remove <span class=\"customMeta\" data-dictid=\"c578fa95fe16927771927ea57020f0\">methanol</span> and its metabolites</li>\n<li><strong>A</strong>ntidote:<strong> F</strong>omepizole or <strong>E</strong>thanol to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> ADH</li>\n<li><strong>F</strong>olinic acid or <span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\">folic acid</span> to enhance <span class=\"customMeta\" data-dictid=\"8723cfd7d21692777203cc8312c239\">formate</span> metabolism.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old man with a history of chronic alcohol abuse is admitted to the hospital due to severe alcohol withdrawal symptoms. After stabilisation, he expresses his desire to overcome his alcohol dependence and seeks assistance from the healthcare team. Which of the following is not an anti-craving drug commonly used in the management of alcohol dependence?", "options": [{"label": "A", "text": "Naltrexone", "correct": false}, {"label": "B", "text": "Acamprosate", "correct": false}, {"label": "C", "text": "Disulfiram", "correct": true}, {"label": "D", "text": "Topiramate", "correct": false}], "correct_answer": "C. Disulfiram", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:732px\">\n<tbody>\n<tr>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>FDA-</strong><br/>\n<strong>approved anti-craving drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Naltrexone (Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces cravings and desire to drink</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acamprosate (Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Modulates <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> &amp; GABA systems</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces cravings and helps maintain abstinence</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Not FDA-</strong><br/>\n<strong>approved (off-label use)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Baclofen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GABA agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Helps with alcohol withdrawal symptoms</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gabapentin</p>\n<p>&amp; Topiramate (Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Modulates GABA &amp; <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> systems</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Helps with alcohol withdrawal symptoms</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FzotK6a3NPC6NRCmEHOQ1749048944.mp3", "video": ""}, {"text": "Which of the following statements regarding the mechanism of action of disulfiram is incorrect?", "options": [{"label": "A", "text": "Disulfiram inhibits the enzyme aldehyde dehydrogenase, leading to an accumulation of acetaldehyde in the body.", "correct": false}, {"label": "B", "text": "Acetaldehyde accumulation results in unpleasant symptoms such as nausea, vomiting, and headache when alcohol is consumed.", "correct": false}, {"label": "C", "text": "Disulfiram increases the production of dopamine in the brain, reducing the desire to consume alcohol.", "correct": true}, {"label": "D", "text": "Disulfiram therapy is often used as an adjunct in the treatment of alcohol dependence.", "correct": false}], "correct_answer": "C. Disulfiram increases the production of dopamine in the brain, reducing the desire to consume alcohol.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XMaVs2H4TcoTK33XXZ1M1749049100.mp3", "video": ""}, {"text": "A patient recovering from alcohol dependence on disulfiram developed a fungal infection and was given an antifungal medication. Shortly after, the patient developed symptoms reminiscent of a disulfiram-like reaction. Which of the following antifungal drugs is most likely to have caused this reaction?", "options": [{"label": "A", "text": "Fluconazole", "correct": false}, {"label": "B", "text": "Clotrimazole", "correct": false}, {"label": "C", "text": "Amphotericin B", "correct": false}, {"label": "D", "text": "Griseofulvin", "correct": true}], "correct_answer": "D. Griseofulvin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6tHGzcPgU78YNSLo46021749049217.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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The pain started 35 minutes ago while he was walking and has not improved with rest. On physical examination, ECG showed ST-segment depression in the anterior leads. What is the most appropriate initial treatment for managing this condition?", "options": [{"label": "A", "text": "Atenolol", "correct": false}, {"label": "B", "text": "Nitroglycerin", "correct": true}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Clopidogrel", "correct": false}], "correct_answer": "B. Nitroglycerin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yLZSlia27xf0mDslUgQq1748079108.mp3", "video": ""}, {"text": "Which of the following statements correctly describes the use of beta-blockers in the management of chronic angina?", "options": [{"label": "A", "text": "It dilates coronary blood vessels by blocking beta-2 receptors in the heart.", "correct": false}, {"label": "B", "text": "It decreases myocardial oxygen demand by reducing heart rate and contractility.", "correct": true}, {"label": "C", "text": "It dilates coronary arteries directly, improving blood flow to the myocardium.", "correct": false}, {"label": "D", "text": "It increases the workload on the heart by increasing blood pressure.", "correct": false}], "correct_answer": "B. It decreases myocardial oxygen demand by reducing heart rate and contractility.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/oJhdG7G2e85ecGCrvZkE1724322344.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardioselective <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> blocker</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Selective <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> blocker</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blocks beta-1 &gt; beta-2</li>\n<li>Mnemonic- <strong>MAN B</strong>\n<ul>\n<li>Metoprolol</li>\n<li>Atenolol</li>\n<li>Nebivolol</li>\n<li>Bisoprolol</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blocks beta-1 and beta-2 equally.</li>\n<li><strong>Propranolol</strong></li>\n<li>Contraindications- <span class=\"customMeta\" data-dictid=\"1af6c1e77d169277720168838edbbe\">Vasospastic</span> or prinzmetal angina.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GZjDhNgCTTvdGgcuD9ij1748079244.mp3", "video": ""}, {"text": "A 40-year-old female presents to the emergency with recurrent chest pain over the past few days. The pain occurs at rest, often waking her from sleep and resolves spontaneously. Her resting ECG shows transient ST-segment elevation with a normal coronary angiogram. Which of the following most appropriately matches the treatment and mechanism of action of the drug of choice? Drug Mechanism of Action 1. Nitroglycerin a. Reduce myocardial oxygen demand by decreasing heart rate. 2. Propranolol b. Vasodilates coronary arteries by increasing cGMP. 3. Nifedipine c. Inhibit calcium influx into vascular smooth muscle and cardiac cells. 4. Aspirin d. Inhibits platelet aggregation by irreversibly acetylating cyclooxygenase.", "options": [{"label": "A", "text": "3 and c", "correct": true}, {"label": "B", "text": "2 and b", "correct": false}, {"label": "C", "text": "1 and d", "correct": false}, {"label": "D", "text": "4 and a", "correct": false}], "correct_answer": "A. 3 and c", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Calcium channel blockers</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>DHP </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Non-DHP</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MOA: <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">Coronary</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> dilator</li>\n<li>Drugs: Amlodipine, <span class=\"customMeta\" data-dictid=\"7c0ddaeead1692777193d6ef9ffbf0\">Nifedipine</span> and Felodipine.</li>\n<li>Use: Chronic Vasospastic angina</li>\n<li>Combined with beta-blockers to reduce the risk of tachycardia.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>MOA- Decrease heart rate and O<sub>2</sub> demand (heart &amp; <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> artery).</li>\n<li>Drugs: Verapamil, Diltiazem</li>\n<li>Uses: Stable angina, <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">Coronary</span> <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> and Vasospastic angina.</li>\n<li>Never combined with beta-blockers (marked bradycardia).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Jjmph9fZJtAfNGr3J0hw1748079574.mp3", "video": ""}, {"text": "Which of the following statements about the pharmacokinetics of nitrates is incorrect?", "options": [{"label": "A", "text": "Nitrates undergo extensive first-pass metabolism in the liver", "correct": false}, {"label": "B", "text": "Nitrates are highly lipid-soluble drugs", "correct": false}, {"label": "C", "text": "Isosorbide mononitrate has 100% bioavailability when taken orally", "correct": false}, {"label": "D", "text": "Pentaerythritol tetranitrate is the shortest-acting nitrate when administered orally", "correct": true}], "correct_answer": "D. Pentaerythritol tetranitrate is the shortest-acting nitrate when administered orally", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nitrates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glyceryl <span class=\"customMeta\" data-dictid=\"cfb872d8e416927772000ca0743ef2\">trinitrate</span> (Nitroglycerin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shortest acting</li>\n<li>Given as oral, sublingual, transdermal, rectal, <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> spray and IV.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isosorbide dinitrate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prodrug; converted to active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> (mononitrate).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Isosorbide mononitrate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oral route</li>\n<li>100% bioavailability<strong> (OPTION C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pentaerythritol tetranitrate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Longest acting<strong> (OPTION D)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Ex04XPfkPgOD5GIJeoZm1748079738.mp3", "video": ""}, {"text": "A 50-year-old male presents to the hospital with an acute onset of chest pain that started 20 minutes ago while he was watching television. An ECG revealed ST-segment elevation in the lateral leads. His medical history includes hypertension and erectile dysfunction for which he is taking sildenafil. Which of the following statements regarding the management of his acute chest pain is true? Nitrates can be safely administered as they enhance vasodilation by increasing cyclic GMP. Nitrates are contraindicated in this patient due to the risk of hypotension. Nitrates are avoided as they cause bradycardia when combined with PDE-5 inhibitors. Nitrates are contraindicated as ECG findings suggest right ventricular dysfunction. Nitrates can be safely administered in this patient after a gap of at least 24 hours.", "options": [{"label": "A", "text": "2 and 5", "correct": true}, {"label": "B", "text": "2, 3 and 4", "correct": false}, {"label": "C", "text": "1, 3, and 5", "correct": false}, {"label": "D", "text": "4 and 5", "correct": false}], "correct_answer": "A. 2 and 5", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ETKZ4glS7Wo0pZDy2zQv1724322428.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nitrates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drug interaction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PDE 5 inhibitors (Sildenafil, Tadalafil):</p>\n<ul>\n<li>Causes massive vasodilation.</li>\n<li><strong>Contraindicated</strong> as they can cause <strong>sudden hypotension</strong> and death.</li>\n<li>Prevent:\n\t\t\t\t<ul>\n<li><strong>24-hour gap with sildenafil</strong></li>\n<li>72-hour gap with tadalafil</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bradycardia and <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">Hypotension</span> (Bezold-Jarisch reflex) .</li>\n<li>Flushing and oedema.</li>\n<li>Reflex tachycardia</li>\n<li>Mondays disease:\n\t\t\t\t<ul>\n<li>Down-regulation of MAD enzymes.</li>\n<li>Tachycardia, dizziness, headache with re-exposure after a drug-free interval.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>SBP &lt; 90 mmHg</li>\n<li>HR &gt;100 BPM and &lt;50 BPM</li>\n<li>Right heart failure</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/iApZNicOPtTp9EWI1LFh1748080215.mp3", "video": ""}, {"text": "Which of the following is a potassium channel opener used to manage resistant angina?", "options": [{"label": "A", "text": "Diazoxide", "correct": false}, {"label": "B", "text": "Nicorandil", "correct": true}, {"label": "C", "text": "Ranolazine", "correct": false}, {"label": "D", "text": "Verapamil", "correct": false}], "correct_answer": "B. Nicorandil", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tj6aJZAGTXr9R01KYHR51748080319.mp3", "video": ""}, {"text": "A 63-year-old male with a history of coronary artery disease presents to the clinic with worsening chest pain during physical exertion. The cardiologist performs a pharmacological stress test to evaluate his coronary blood flow. During the test, the patient's symptoms were exacerbated. Which of the following drugs is not associated with this phenomenon?", "options": [{"label": "A", "text": "Adenosine", "correct": false}, {"label": "B", "text": "Dipyridamole", "correct": false}, {"label": "C", "text": "Nitroglycerin", "correct": true}, {"label": "D", "text": "Nitroprusside", "correct": false}], "correct_answer": "C. Nitroglycerin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/SypRqLuC4HBvm9LSLMx91724322484.png", "https://image.prepladder.com/content/vG3JphwRiz1c2ZD7WHcm1736429483.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs causing <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> steal syndrome</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mnemonic- HINDA</strong></p>\n<ul>\n<li>H: Hydralazine<strong> </strong></li>\n<li>I: <span class=\"customMeta\" data-dictid=\"b7493b6faa169277719091f4c460ff\">Isoflurane</span> (General anaesthetic)</li>\n<li>N: <span class=\"customMeta\" data-dictid=\"4e995cdee9169277719375efd43d38\">Nitroprusside</span> <strong>(OPTION D)</strong></li>\n<li>D: <span class=\"customMeta\" data-dictid=\"1ab668161b16927771865ebc1c2dde\">Dipyridamole</span> (antiplatelet and vasodilator) <strong>(OPTION B)</strong></li>\n<li>A: <span class=\"customMeta\" data-dictid=\"d3f6a49b7416927771802124ccddf0\">Adenosine</span> <strong>(OPTION A)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SxiSDLL4h7XbPDpfIjo51748080504.mp3", "video": ""}, {"text": "A 65-year-old male taking propranolol presents to a cardiologist with worsening chest pain.The cardiologist discusses the option of second-line antianginal drugs to manage his symptoms better. Which of the following statements is correct? Ranolazine acts on sodium channels and is primarily used to treat acute angina. Fasudil acts as a Rho kinase inhibitor used in chronic angina. Trimetazidine inhibits thiolase to shift fuel metabolism from glucose to fatty acids. Ivabradine reduces heart rate by selectively inhibiting the funny current in the sinoatrial node. Ranolazine is contraindicated in patients with existing diabetes mellitus.", "options": [{"label": "A", "text": "2 and 4", "correct": true}, {"label": "B", "text": "1, 2 and 4", "correct": false}, {"label": "C", "text": "1, 2 and 3", "correct": false}, {"label": "D", "text": "2 only", "correct": false}], "correct_answer": "A. 2 and 4", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ranolazine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fasudil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trimetazidine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ivabradine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Target</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blocks late Na channels</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rho kinase</strong> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Rock enzyme)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partial <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid <span class=\"customMeta\" data-dictid=\"224ea8a9e41692777194e81be113d8\">oxidation</span> (<strong>PFOX</strong>) <strong>inhibitor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibit funny current channels in the SA node.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ Myocardial <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> and O<sub>2</sub> demand.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coronary <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> dilatation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <strong>thiolase</strong> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> and shift the fuel metabolism<strong> </strong>from <strong>fatty acids to glucose.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduce heart rate and O<sub>2</sub> demand.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Chronic stable angina</strong></p>\n<p>2. <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> tachycardia</p>\n<p>3. Improves <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> control (lower HbA1c and increase insulin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic <span class=\"customMeta\" data-dictid=\"1af6c1e77d169277720168838edbbe\">vasospastic</span> angina</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second-line anti-anginal drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Chronic stable angina</p>\n<p>2. Chronic heart failure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Q<sub>T</sub> prolongation</p>\n<p>2. Liver failure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Parkinson disease</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"26b77775531692777191cc06a11052\">Luminous</span> phenomenon</p>\n<p>2. Atrial fibrillation</p>\n<p>3. QT Prolongation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3aYsu8UsZyu2FixqGF5E1748080919.mp3", "video": ""}, {"text": "Which of the following correctly describes the mechanism of action of cilnidipine?", "options": [{"label": "A", "text": "Blocks L-type calcium channels in vascular smooth muscle", "correct": false}, {"label": "B", "text": "Blocks T-type calcium channels in cardiac and vascular smooth muscle", "correct": false}, {"label": "C", "text": "Blocks both L-type and N-type calcium channels", "correct": true}, {"label": "D", "text": "Blocks only N-type calcium channels in the nervous system", "correct": false}], "correct_answer": "C. Blocks both L-type and N-type calcium channels", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:630px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>DHP <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> Channel Blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-DHP <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> Channel Blockers</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Examples</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amlodipine, Nifedipine, Felodipine, Cilnidipine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diltiazem, Verapamil</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily block L-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels in <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Block L-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels in the heart</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Angina, rate control in arrhythmias</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peripheral edema, flushing, headache</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bradycardia, heart block, dizziness</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LQNL2ZdMJJlDdWavz0fa1747296463.mp3", "video": ""}, {"text": "Which of the following statements correctly matches with the medications? 1. Metoprolol A. Contraindicated with Non-DHP calcium channel blockers. 2. Ivabradine B. Increase risk of oral ulcers. 3. Trimetazidine C. Abrupt discontinuation can exacerbate angina. 4. Enoxaparin D. Increase risk of Parkinson’s disease. 5. Nicorandil E. Contraindicated in renal insufficiency.", "options": [{"label": "A", "text": "1:C, 2: A, 3:D, 4:E, 5: B", "correct": true}, {"label": "B", "text": "1:A, 2: C, 3:D, 4:B, 5: E", "correct": false}, {"label": "C", "text": "1:D, 2: C, 3:B, 4:A, 5: B", "correct": false}, {"label": "D", "text": "1:C, 2: B, 3:E, 4:A, 5: D", "correct": false}], "correct_answer": "A. 1:C, 2: A, 3:D, 4:E, 5: B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Beta-blockers (e.g metorprolol)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Abrupt discontinuation can exacerbate angina.</li>\n<li><strong>Bradycardia, AV block</strong></li>\n<li><strong>Bronchospasm</strong></li>\n<li>Peripheral vasoconstriction</li>\n<li>Worsening of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> heart failure.</li>\n<li><strong>Worsening of psoriasis</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Ivabradine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contraindicated with diltiazem or verapamil.</li>\n<li>Bradycardia, heart block</li>\n<li><strong>QT prolongation,</strong> atrial fibrillation</li>\n<li>Enhanced lightness in restricted areas of the visual field.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. Trimetazidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increase <span class=\"customMeta\" data-dictid=\"17cd3771bb1692777190950c142dbe\">incidence</span> of <strong>Parkinson’s disease.</strong></li>\n<li>Agranulocytosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4.Low-molecular-weight <span class=\"customMeta\" data-dictid=\"050e27829716927771885eddb2620c\">heparin</span> (e.g., enoxaparin, dalteparin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Accumulation in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> insufficiency.</strong></li>\n<li>Heparin-induced thrombocytopenia.</li>\n<li>Raised liver enzymes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5. Nicorandil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypotension</li>\n<li><strong>Headache</strong></li>\n<li><strong>Buccal and GI ulcers</strong></li>\n<li><strong>Contraindicated with PDE5 inhibitor</strong>.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rPTIJpUX1y2z30CAPtPG1748002422.mp3", "video": ""}, {"text": "A 60-year-old male presents to the clinic complaining of chest pain. He describes the pain occurring with exertion and relief by rest. His baseline ECG is unremarkable. Which of the following drugs is most likely to worsen his condition?", "options": [{"label": "A", "text": "Nifedipine", "correct": true}, {"label": "B", "text": "Felodipine", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Amlodipine", "correct": false}], "correct_answer": "A. Nifedipine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on HR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use in Angina</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nifedipine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dihydropyridine (short)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reflex <strong>↑ HR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>May worsen stable angina</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Felodipine (Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dihydropyridine (longer)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal HR increase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generally safe in stable angina</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diltiazem (Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-dihydropyridine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>↓ HR, ↓ contractility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preferred in <strong>rate control &amp; angina</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amlodipine (Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dihydropyridine (long-acting)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neutral or mild ↑ HR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in <strong>chronic stable angina</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1aNEs0jKHYDhnOhqvZHL1748081051.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 21 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs is used in the management of angina pectoris and hypertension and has anti-arrhythmic properties?", "options": [{"label": "A", "text": "Enalapril", "correct": false}, {"label": "B", "text": "Amlodipine", "correct": false}, {"label": "C", "text": "Verapamil", "correct": true}, {"label": "D", "text": "Hydrochlorothiazide", "correct": false}], "correct_answer": "C. Verapamil", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-dihydropyridines (non-DHPs) <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockers.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks L-type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels in <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> and <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> contractility</p>\n<p>Dilates <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> arteries</p>\n<p>Slows <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> through AV node</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xgYXmoEYcE2TPa0uBrNh1746108730.mp3", "video": ""}, {"text": "Three patients come to the clinic with hypertension: Patient A: A 52-year-old known hypertensive who has tried maximum doses of three different antihypertensive drugs without success; current BP 168/104 mm Hg . Patient B: A 30-year-old pregnant woman with a BP of 158/98 mm Hg. Patient C: A 65-year-old man with diabetes mellitus and a BP of 160/100 mm Hg. Choose the correct antihypertensive regimen for the above patients.", "options": [{"label": "A", "text": "Patient A: Existing regimen + Spironolactone Patient B: Labetalol Patient C: ACE inhibitors", "correct": true}, {"label": "B", "text": "Patient A: Existing regimen + loop diuretics Patient B: ACE inhibitors Patient C: Beta-blockers", "correct": false}, {"label": "C", "text": "Patient A: Sodium nitroprusside Patient B: Thiazides Patient C: Labetalol", "correct": false}, {"label": "D", "text": "Patient A: Labetalol + Spironolactone Patient B: Calcium channel blockers Patient C: Beta-blockers", "correct": false}], "correct_answer": "A. Patient A: Existing regimen + Spironolactone Patient B: Labetalol Patient C: ACE inhibitors", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:658px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Patient A</strong></p>\n<p>“Resistant hypertension” is not controlled by 3 different drugs (at maximum tolerable dose).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drugs useful in this patient are <em>Thiazides+ <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> Inhibitors/ARBs + Calcium Channel Blockers.</em></li>\n<li>Additionally, <strong>Potassium-sparing diuretics</strong> such as Spironolactone or <span class=\"customMeta\" data-dictid=\"7833fe56401692777187f075d48c5a\">eplerenone</span> must be added in case of Resistant hypertension.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Patient B</strong></p>\n<p>Pregnant woman with hypertension.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>DOC: </strong>Labetaolol (Beta-blocker)</li>\n<li>If chronic <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> develops: Alpha methyldopa.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safe antihypertensives during pregnancy</strong></p>\n<p>Labetalol, Hydralazine, Methyldopa, and Calcium channel blockers like Nifedipine. (LHMC- Lady Hardinge Medical College)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unsafe <span class=\"customMeta\" data-dictid=\"a9952795951692777181001d03753a\">antihypertensive</span> drugs during pregnancy:</strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>ACE inhibitors:</strong> Can lead to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> in the fetus, causing <span class=\"customMeta\" data-dictid=\"41fc142ae61692777194c3f69d3d74\">oligohydramnios</span> and leading to POTTER sequence (Pulmonary hypoplasia, Oligohydramnios, Twisted/wrinkled skin, Twisted Potter faces, Extremity defects, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> agenesis).</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Thiazides/Loop diuretics/Beta-blockers:</strong> Bear the risk of <span class=\"customMeta\" data-dictid=\"797686400a16927771956b27d401ff\">placental</span> ischemia, which can be fatal to the fetus.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Patient C</strong></p>\n<p>Hypertensive patients with diabetes as a comorbidity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>ACE inhibitors are ideal for this patient because they are nephroprotective against diabetes-induced nephropathy.</li>\n<li>Beta-blockers should be avoided in <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> patients as they can mask the <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> symptoms of hypoglycemia, which can be fatal.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:561px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><em>(Thiazides+ ACE Inhibitors/ARBs + Calcium Channel Blockers) </em>+ <strong>Potassium-sparing diuretics</strong> (Spironolactone or eplerenone)/ <strong>Beta-Blockers</strong> (if the patient is in Heart failure post-myocardial infarction).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SItrZl8msAS5tWxXlEKI1746110911.mp3", "video": ""}, {"text": "A 38-year-old woman comes to the emergency department due to a throbbing headache. On vital examination, BP is 210/140 mm Hg. She is started on a Nitroprusside IV drip. After 8 hours, develop lactic acidosis and neurological symptoms. She is diagnosed with nitroprusside-induced cyanide toxicity. Which of the following drug combinations is used to treat this condition?", "options": [{"label": "A", "text": "Pralidoxime + atropine", "correct": false}, {"label": "B", "text": "Sodium nitrite + sodium thiosulfate + hydroxocobalamin", "correct": true}, {"label": "C", "text": "Activated charcoal + N-acetylcysteine", "correct": false}, {"label": "D", "text": "Sodium nitrite only", "correct": false}], "correct_answer": "B. Sodium nitrite + sodium thiosulfate + hydroxocobalamin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ppgkIPrzVpHHY4hCSla51736434048.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:658px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Option A:</strong> <strong>Pralidoxime + <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">atropine</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This combination of drugs serves as an <span class=\"customMeta\" data-dictid=\"5e612ce1381692777181adc76f11e6\">antidote</span> for <span class=\"customMeta\" data-dictid=\"505a21f8451692777194a113951c68\">organophosphate</span> poisoning.</li>\n<li>Atropine is used for <span class=\"customMeta\" data-dictid=\"d63d6eeae016927771825f69be5e9c\">atropinization</span> of all the <span class=\"customMeta\" data-dictid=\"c10496dcc416927771937d7280d782\">nicotinic</span> and <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors thus preventing their further stimulation, while <span class=\"customMeta\" data-dictid=\"c08d723a9f16927771968c414d08e6\">pralidoxime</span> is used to reverse the inhibited <span class=\"customMeta\" data-dictid=\"63b92227451692777180db3901b72f\">acetylcholinesterase</span> and <span class=\"customMeta\" data-dictid=\"8ec8ab5e741692777197e5759c78c1\">reactivate</span> the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> .</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Option C:</strong> <strong>Activated <span class=\"customMeta\" data-dictid=\"e7626b047e169277718484971217b8\">charcoal</span> + N-acetyl <span class=\"customMeta\" data-dictid=\"dabfa103741692777185dac756c49b\">cysteine</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This combination of drugs is used to treat acetaminophen/paracetamol poisoning.</li>\n<li>Activated <span class=\"customMeta\" data-dictid=\"e7626b047e169277718484971217b8\">charcoal</span> binds to the unabsorbed <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> present in the gut which can be flushed out using a lavage, while N-acetyl <span class=\"customMeta\" data-dictid=\"dabfa103741692777185dac756c49b\">cysteine</span> serves to replenish the <span class=\"customMeta\" data-dictid=\"f945849e691692777188ad7ce5b5e2\">glutathione</span> stores which binds to the toxic <span class=\"customMeta\" data-dictid=\"fceb6bf8d01692777192b8b179f554\">metabolite</span> of <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> <em>N</em>-acetyl-<em>p</em>-benzoquinoneimine.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Option D: </strong><strong>Sodium <span class=\"customMeta\" data-dictid=\"8866b36aa016927771938ffb10b429\">nitrite</span> only </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>If only sodium <span class=\"customMeta\" data-dictid=\"8866b36aa016927771938ffb10b429\">nitrite</span> is used, the <span class=\"customMeta\" data-dictid=\"d6a309acb11692777185fa29e190ec\">cyanmethemoglobin</span> formed will dissociate back into <span class=\"customMeta\" data-dictid=\"2cf30efe831692777185e200487656\">cyanide</span> and <span class=\"customMeta\" data-dictid=\"4b68d201f1169277719205f9339df9\">methemoglobin</span> before being excreted out of the body.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyanide poisoning</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sodium <span class=\"customMeta\" data-dictid=\"8866b36aa016927771938ffb10b429\">nitrite</span> + sodium <span class=\"customMeta\" data-dictid=\"c7e95d7fc4169277720098ae4b326f\">thiosulfate</span> + hydroxocobalamin.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Organophosphate poisoning</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pralidoxime + atropine.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Paracetamol poisoning</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Activated <span class=\"customMeta\" data-dictid=\"e7626b047e169277718484971217b8\">charcoal</span> + N-acetyl cysteine.</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JEJcgxGtcuxy3fw1oyIz1746110705.mp3", "video": ""}, {"text": "A 58-year-old man comes to the emergency department due to loss of consciousness and severe hypotension. He has a history of angina for which he takes nitroglycerin and metoprolol tablets. He was recently prescribed sildenafil to help him with his erectile dysfunction. Which of the following is true about the concomitant use of nitrates and Sildenafil?", "options": [{"label": "A", "text": "Sildenafil should be avoided for 24 hours before and after use of nitrates.", "correct": true}, {"label": "B", "text": "Sildenafil and nitrates can be taken together if doses are low.", "correct": false}, {"label": "C", "text": "Sildenafil are absolutely contraindicated with those taking nitrates.", "correct": false}, {"label": "D", "text": "None of the above.", "correct": false}], "correct_answer": "A. Sildenafil should be avoided for 24 hours before and after use of nitrates.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ddpTff5ebpwPSpnyBHZv1736433858.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0dM0jVWI5MfFxolEsVyI1746110535.mp3", "video": ""}, {"text": "A 68-year-old man with congestive heart failure who is on captopril and digoxin is being reviewed for worsening of his symptoms. A potassium channel opener is added along with nitrates to his regimen as a cardioprotective agent. Which of the following is the K+ channel opener most likely to be?", "options": [{"label": "A", "text": "Minoxidil", "correct": false}, {"label": "B", "text": "Diazoxide", "correct": false}, {"label": "C", "text": "Hydralazine", "correct": false}, {"label": "D", "text": "Nicorandil", "correct": true}], "correct_answer": "D. Nicorandil", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Minoxidil (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minoxidil is a <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> channel opener that causes <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> near hair follicles, improving <span class=\"customMeta\" data-dictid=\"c1f53b6403169277719280fe54916f\">microcirculation</span> and stimulating hair growth, but it does not provide cardioprotection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diazoxide (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diazoxide opens potassium channels in pancreatic <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> cells, reducing <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> secretion. It is primarily used in <span class=\"customMeta\" data-dictid=\"43b7327590169277719092c556b0b6\">insulinoma</span> to prevent <span class=\"customMeta\" data-dictid=\"e3c971ee8c1692777189899cba151f\">hyperinsulinemia</span> but does not provide cardioprotection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hydralazine (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hydralazine is a direct arteriolar vasodilator, reducing <span class=\"customMeta\" data-dictid=\"38d395efa2169277718025e142bd0e\">afterload</span> and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> workload.</li>\n<li>It has <span class=\"customMeta\" data-dictid=\"1f3c08447d16927771819ccd566468\">antioxidant</span> properties that reduce <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> stress.</li>\n<li>It increases <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> blood flow, enhancing GFR and reducing circulating volume, thus decreasing preload.</li>\n<li>While it helps in <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> and hypertension, it lacks specific <span class=\"customMeta\" data-dictid=\"51ae2c971016927771839f0c787a6f\">cardioprotective</span> actions related to ischemic heart conditions or dual nitrate-like effects seen with Nicorandil.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DbgZ0uojb4dKKme4bkiA1746110374.mp3", "video": ""}, {"text": "A 68-year-old man comes to the ER with complaints of chest pain radiating to his left arm for the last 30 minutes. He has a history of diabetes, hyperlipidemia and hypertension. ECG showed features of stable angina. Sublingual glyceryl trinitrate was administered, which provided pain relief. What is the mechanism of action of this drug?", "options": [{"label": "A", "text": "It donates nitric oxide, which activates guanylyl cyclase, thus increasing cytosolic cGMP.", "correct": true}, {"label": "B", "text": "It hyperphosphorylates Myosin light chain kinase.", "correct": false}, {"label": "C", "text": "It blocks the L-type voltage-gated calcium channel in the vascular smooth muscle.", "correct": false}, {"label": "D", "text": "It inhibits the degradation of cytosolic cGMP.", "correct": false}], "correct_answer": "A. It donates nitric oxide, which activates guanylyl cyclase, thus increasing cytosolic cGMP.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/AM3JTVSRKbRUaZooN4E51736433701.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:708px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Arterial dilator</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The K+ channel opener causes K+ to move out of the <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle, causing hyperpolarisation and thus leading to vasodilation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydralazine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertensive emergency;</p>\n<p>Preeclampsia;</p>\n<p>Chronic heart failure.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drug-induced lupus.</p>\n<p>May <span class=\"customMeta\" data-dictid=\"eba5ba77ec169277719688fab52fb0\">precipitate</span> <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> in <span class=\"customMeta\" data-dictid=\"4c453b57b51692777183ad486096a9\">CAD</span> patients.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minoxidil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alopecia (used in combination with <span class=\"customMeta\" data-dictid=\"b249ba1c6a16927771821b83b1fd9b\">aromatase</span> inhibitor: Finasteride)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hirsutism in females.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diazoxide</p>\n<p>(it blocks K+ channels in the <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> cells of the pancreas, thus reducing <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> secretion)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Insulinoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperglycemia</p>\n<p>Fluid retention.</p>\n<p>Hypotension (with IV injection)</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium channel blockers</p>\n<p>blocks the L-type voltage-gated <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel in the <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle (Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dihydropyridine</p>\n<p>(vessels &gt; heart)</p>\n<p>Nicardipine</p>\n<p>Nifedipine</p>\n<p>Felodipine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension and Angina.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Edema</p>\n<p>Flushing</p>\n<p>Headaches</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-dihydropyridine</p>\n<p>(heart &gt; vessels)</p>\n<p>Verapamil</p>\n<p>Diltiazem</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Arrhythmia and Angina</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bradyarrhythmia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phosphodiesterase inhibitors-5’</p>\n<p>It inhibits the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> responsible for the <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">degradation</span> of cGMP, thus keeping the cytosolic <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> elevated</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sildenafil</p>\n<p>Tadalafil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erectile <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> and</p>\n<p>Pulmonary <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> hypertension.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flushing</p>\n<p>Nasal congestion</p>\n<p>Dyspepsia</p>\n<p>Hypotension</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Venous <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NO donor</p>\n<p>It increases cytosolic cGMP, which activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> that dephosphorylates <span class=\"customMeta\" data-dictid=\"99c8e09d6f1692777193d7716ab6eb\">Myosin</span> <span class=\"customMeta\" data-dictid=\"578fe8d7dd16927771913c847ed254\">light chain</span> kinase, thus inhibiting actin-myosin interaction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nitrates</p>\n<p>(Enzyme dependent)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Angina</p>\n<p>Cyanide poisoning</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flushing</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nitroprusside (Enzyme independent.)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertensive emergencies (rapid action)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyanide toxicity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Arterial + <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Has Dual action:</p>\n<p>NO donor + <span class=\"customMeta\" data-dictid=\"5abb3a7e7f1692777182a8f4c42522\">ATP</span> sensitive K+ channel opener.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nicorandil</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Angina</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flushing dizziness</p>\n<p>Aphthous ulcers</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jBnHiRJpDeh1emEEpKZ51746109827.mp3", "video": ""}, {"text": "Which of the following medications is contraindicated with metoprolol due to significant drug interactions?", "options": [{"label": "A", "text": "Amlodipine", "correct": false}, {"label": "B", "text": "Verapamil", "correct": true}, {"label": "C", "text": "Nifedipine", "correct": false}, {"label": "D", "text": "Nimodipine", "correct": false}], "correct_answer": "B. Verapamil", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RrzsfhqzsuQwgmESk3Fd1746109612.mp3", "video": ""}, {"text": "A 65-year-old patient with hypertension and stable angina pectoris reports experiencing excessive swelling in the lower extremities, headaches, and overgrowth of gum tissue (gingival hyperplasia) after being on a calcium channel blocker for several months. Which of the following calcium channel blockers most likely cause these adverse effects?", "options": [{"label": "A", "text": "Verapamil", "correct": false}, {"label": "B", "text": "Amlodipine", "correct": false}, {"label": "C", "text": "Nimodipine", "correct": false}, {"label": "D", "text": "Diltiazem", "correct": true}], "correct_answer": "D. Diltiazem", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dihydropyridine CCBs </strong></p>\n<p><strong>(e.g., Amlodipine, Nimodipine)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-dihydropyridine CCBs (e.g., Verapamil, Diltiazem)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peripheral Edema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Headache</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Flushing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gingival Hyperplasia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common (especially with diltiazem)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dizziness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reflex Tachycardia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common (due to negative <span class=\"customMeta\" data-dictid=\"d44f29df6116927771902150f69464\">inotropic</span> effect)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Constipation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nausea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fatigue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NlCTArNXCeEVgijyD8Yk1746109287.mp3", "video": ""}, {"text": "Which of the following calcium channel blockers is cerebroselective, specifically for preventing and managing cerebral vasospasm following aneurysmal subarachnoid haemorrhage?", "options": [{"label": "A", "text": "Amlodipine", "correct": false}, {"label": "B", "text": "Verapamil", "correct": false}, {"label": "C", "text": "Nimodipine", "correct": true}, {"label": "D", "text": "Diltiazem", "correct": false}], "correct_answer": "C. Nimodipine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LrwnM4kdHZh4iwYt3oFf1746109128.mp3", "video": ""}, {"text": "A 48-year-old woman with a 10-year history of poorly controlled hypertension visits your clinic for follow-up. Her blood pressure is 158/96 mmHg, despite being on lisinopril and hydrochlorothiazide. Her serum creatinine and potassium levels are within normal limits. Which calcium channel blockers would be the most appropriate addition to her long-term blood pressure control treatment regimen?", "options": [{"label": "A", "text": "Nifedipine", "correct": false}, {"label": "B", "text": "Nicardipine", "correct": false}, {"label": "C", "text": "Clevidipine", "correct": false}, {"label": "D", "text": "Amlodipine", "correct": true}], "correct_answer": "D. Amlodipine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:700px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rationale for Choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nifedipine (Option A) </strong>Short-acting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily used for <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> pectoris</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not recommended for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management due to its short duration of action and potential for <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tachycardia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nicardipine</strong> (Option B) Short-acting</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Commonly used in the management of <span class=\"customMeta\" data-dictid=\"dd2daa0c6216927771893c9cab82d9\">hypertensive</span> emergencies and <span class=\"customMeta\" data-dictid=\"00d2d5474716927771957a22e66ad9\">perioperative</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> or severe <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> in the <span class=\"customMeta\" data-dictid=\"901bf573f216927771905f0abedca2\">intensive</span> care unit.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The short duration of action makes it less suitable for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clevidipine (Option C)</strong> Ultra-short-acting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Very short <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> makes it unsuitable for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amlodipine (Option D)</strong> Long-acting.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recommended as a first-line or add-on therapy for the long-term management of hypertension</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preferred choice due to its long duration of action (up to 24 hours), once-daily dosing, and effectiveness in <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> with good tolerability.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NbYGVNYMPwpFJtkztXaB1746108977.mp3", "video": ""}, {"text": "Match the following 1. Aliskiren a) Central sympatholytic 2. Lisinopril b) Acts on JG cells of the kidney to reduce renin release 3. Losartan c) Direct renin inhibitor 4. Clonidine d) Prevents formation of Angiotensin 2 5. Beta-blockers e) Block Angiotensin 1 receptor", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d, 5-e", "correct": false}, {"label": "B", "text": "1-b, 2-c, 3-d, 4-e, 5-a", "correct": false}, {"label": "C", "text": "1-c, 2-d, 3-e, 4-a, 5-b", "correct": true}, {"label": "D", "text": "1-d, 2-e, 3-a, 4-b, 5-c", "correct": false}], "correct_answer": "C. 1-c, 2-d, 3-e, 4-a, 5-b", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KHoznlfcAUmg7aATPLgs1736432958.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name of drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aliskiren</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks the formation of <span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\">angiotensin</span> 1, which decreases BP.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lisinopril</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACE inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks the conversion of <span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\">angiotensin</span> 1 to <span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\">angiotensin</span> 2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Losartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ARB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\">angiotensin</span> 1 receptor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clonidine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Central sympatholytic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It acts on <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> 2A receptors, decreasing <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> from the brain and reducing <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metoprolol, Atenolol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Beta-blockers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Act on JG cells of the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> to reduce <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> release.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1hysmiB3NRfIQpMtxWkM1746103413.mp3", "video": ""}, {"text": "Which of the following drugs is classified as a non-dihydropyridine (non-DHP) calcium channel blocker?", "options": [{"label": "A", "text": "Amlodipine", "correct": false}, {"label": "B", "text": "Felodipine", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": true}, {"label": "D", "text": "Nifedipine", "correct": false}], "correct_answer": "C. Diltiazem", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Main Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-dihydropyridines (non-DHPs).</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diltiazem</p>\n<p>(Benzothiazepines)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate effects on <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> muscle and <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> smooth muscle.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Verapamil</p>\n<p>(Phenylalkylamines)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It primarily affects <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> muscle, leading to negative <span class=\"customMeta\" data-dictid=\"d44f29df6116927771902150f69464\">inotropic</span> effects and slow <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> through the AV node.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dihydropyridines</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amlodipine, Bepridil, Felodipine, Isradipine, Nicardipine, Nifedipine, Nisoldipine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It predominantly acts on the smooth <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> muscle, resulting in <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> and <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> resistance; some also affect the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> muscle.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/V7XaWe2Yek7efMajuJAg1746108324.mp3", "video": ""}, {"text": "Which of the following statements about the pharmacological properties of ARBs is correct? 1) Losartan blocks the thromboxane A2 receptor, resulting in an antiplatelet effect and uricosuric action. 2) Irbesartan blocks the SA node in the heart, making it effective in atrial fibrillation. 3) Telmisartan acts as a PPAR-alpha agonist, which improves insulin sensitivity.", "options": [{"label": "A", "text": "1,2,3", "correct": true}, {"label": "B", "text": "1,2", "correct": false}, {"label": "C", "text": "Only 3", "correct": false}, {"label": "D", "text": "1,3", "correct": false}], "correct_answer": "A. 1,2,3", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ARB’s</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Losartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acts as a competitive <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> and <span class=\"customMeta\" data-dictid=\"459918ac4616927771903ea16da4c9\">inverse</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> at AT1 receptors, demonstrating <span class=\"customMeta\" data-dictid=\"f224b5200c16927771980b12f94a4d\">selectivity</span> for AT1 over AT2 receptors.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, heart failure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It does not interfere with <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> degradation, reducing the risk of cough.</li>\n<li>It possesses an <span class=\"customMeta\" data-dictid=\"257da9409416927771815e64ee5df1\">antiplatelet</span> effect by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> <span class=\"customMeta\" data-dictid=\"96309dcb1c169277720072ad555473\">thromboxane</span> A2 receptors.</li>\n<li>It exhibits <span class=\"customMeta\" data-dictid=\"3901ee0da81692777201d1563c9f5f\">uricosuric</span> action, which is potentially beneficial for gout.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Irbesartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Functions as a selective competitive <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> of AT1 receptors.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, atrial fibrillation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Effective in <span class=\"customMeta\" data-dictid=\"e6a04221a41692777182825f0f08da\">atrial fibrillation</span> by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the <span class=\"customMeta\" data-dictid=\"4ef079efd416927771987c9211b8d3\">sinoatrial</span> (SA) <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> in the heart.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Telmisartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acts as a selective competitive <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> of AT1 receptors.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, prevention of <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> events, management of <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> nephropathy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acts as a <span class=\"customMeta\" data-dictid=\"c0d194cb5b16927771957905b7aad6\">peroxisome</span> proliferator-activated receptor-gamma (PPAR-γ) agonist, similar to pioglitazone.</li>\n<li>Stimulation of PPAR-γ leads to improved <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> sensitivity and <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> risk of <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes by decreasing <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> resistance.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wkRaeS3vFUn6I4NwQzBH1746108190.mp3", "video": ""}, {"text": "Which angiotensin II receptor blocker (ARB) is considered the most potent and has the highest affinity for the AT-1 receptor?", "options": [{"label": "A", "text": "Losartan", "correct": false}, {"label": "B", "text": "Valsartan", "correct": false}, {"label": "C", "text": "Candesartan", "correct": true}, {"label": "D", "text": "Irbesartan", "correct": false}], "correct_answer": "C. Candesartan", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:609px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\">angiotensin</span> II receptors (AT-1), exerting its pharmacological effects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is commonly prescribed for various conditions, including hypertension, heart failure, and <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> nephropathy, with off-label uses for conditions such as <span class=\"customMeta\" data-dictid=\"75a3b02a801692777184b9cb7f0c0a\">cerebrovascular</span> accident (stroke), left <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> hypertrophy, and migraines.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dizziness, hypotension, hyperkalemia, cough, headache, back pain, angioedema, upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Specific Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Candesartan is associated with a risk of teratogenicity, evidenced by a boxed warning for <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> toxicity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hPgAhrteC2CBfe1LMLCz1746107934.mp3", "video": ""}, {"text": "Which of the following adverse effects of ACE inhibitors is associated with increased bradykinin levels?", "options": [{"label": "A", "text": "Hypotension", "correct": false}, {"label": "B", "text": "Hyperkalemia", "correct": false}, {"label": "C", "text": "Cough", "correct": true}, {"label": "D", "text": "Dysgeusia", "correct": false}], "correct_answer": "C. Cough", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:659px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decrease in blood pressure, especially upon <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of therapy or with <span class=\"customMeta\" data-dictid=\"b5bd69c9791692777186a40f45ffb6\">dosage</span> increases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperkalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cough</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Persistent dry cough, possibly due to <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> buildup in the lungs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Angioedema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to increased <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> levels, <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of deeper layers of skin, particularly around the eyes and lips, can be life-threatening.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rashes/Urticaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Skin reactions like rashes or <span class=\"customMeta\" data-dictid=\"14ccc7cf1c1692777189d4fb9d1fb5\">hives</span> occur in a small percentage of users.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dysgeusia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reversible taste changes are more common with captopril.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rare Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Granulocytopenia (low white blood cells) and <span class=\"customMeta\" data-dictid=\"1f58deccf71692777196e64781a01a\">proteinuria</span> (excess protein in urine) are more concerning in patients with <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Failure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible in patients with <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> due to decreased <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> filtration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fetal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACE inhibitors are contraindicated during pregnancy due to potential harm to the fetus, including <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> damage due to <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of the <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> renin-angiotensin system.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rkTy2oEDt68AlfhEbJJx1746107787.mp3", "video": ""}, {"text": "A 58-year-old female with hypertension and heart failure is prescribed an ACE inhibitor for blood pressure control. What is the most significant drug interaction to be cautious about when prescribing ACE inhibitors?", "options": [{"label": "A", "text": "Calcium channel blockers", "correct": false}, {"label": "B", "text": "Loop diuretics", "correct": false}, {"label": "C", "text": "Statins", "correct": false}, {"label": "D", "text": "Potassium-sparing diuretics", "correct": true}], "correct_answer": "D. Potassium-sparing diuretics", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:700px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Interaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Implication</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">Potassium</span> Supplements/K-sparing diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <span class=\"customMeta\" data-dictid=\"8bf09336411692777189d1a79bf6a5\">hyperkalemia</span> due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> by <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors combined with potassium-retaining agents.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monitoring <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels is crucial to avoid hyperkalemia, which can cause serious <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> issues such as arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + NSAIDs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NSAIDs can reduce the anti-hypertensive effects of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors and decrease <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> blood flow, increasing the risk of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure (ARF) or oliguria.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use caution when combining NSAIDs with <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors, and closely monitor <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function, particularly in high-risk patients.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Lithium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACE inhibitors can increase the <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of lithium, potentially leading to <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> toxicity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monitor <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> levels carefully when starting or adjusting <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors in patients taking lithium, and adjust the <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> <span class=\"customMeta\" data-dictid=\"b5bd69c9791692777186a40f45ffb6\">dosage</span> as needed.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Antacids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced <span class=\"customMeta\" data-dictid=\"cf91922bb816927771839a51f2d1e6\">bioavailability</span> of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors due to binding with antacids.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Administer <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors at least two hours before or after antacids to maintain their efficacy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diuretics enhance the <span class=\"customMeta\" data-dictid=\"bf6247405e16927771891b6a068d36\">hypotensive</span> effects of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors by depleting sodium and raising <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> levels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In patients already on diuretics, start <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors at a low dose to minimise the risk of excessive <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> reduction initially.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yA5JKfrRMmSfuELCSGkw1745662057.mp3", "video": ""}, {"text": "A 62-year-old female presents for management of her hypertension and heart failure. She has a past medical history of type 2 diabetes mellitus, hyperlipidemia, and chronic kidney disease (stage 3). The initiation of an ACE inhibitor is considered. Which of the following are the uses of ACE inhibitors in this scenario?", "options": [{"label": "A", "text": "Reduction of proteinuria", "correct": false}, {"label": "B", "text": "Reduction of preload and afterload", "correct": false}, {"label": "C", "text": "Prevention of diabetic nephropathy", "correct": false}, {"label": "D", "text": "All the above", "correct": true}], "correct_answer": "D. All the above", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kKoKk2BWY0W3OAb0ruTI1746107648.mp3", "video": ""}, {"text": "Which of the following ACEI is not a prodrug?", "options": [{"label": "A", "text": "Captopril", "correct": true}, {"label": "B", "text": "Enalapril", "correct": false}, {"label": "C", "text": "Fosinopril", "correct": false}, {"label": "D", "text": "Ramipril", "correct": false}], "correct_answer": "A. Captopril", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kS2MBS9njAtgsZ4dQEXt1746107363.mp3", "video": ""}, {"text": "Which of the following ACEIs/ARBs are most safe in renal failure?", "options": [{"label": "A", "text": "Captopril and Losartan", "correct": false}, {"label": "B", "text": "Fosinopril and Telmisartan", "correct": true}, {"label": "C", "text": "Enalapril and Candisartan", "correct": false}, {"label": "D", "text": "Benazepril and Losartan", "correct": false}], "correct_answer": "B. Fosinopril and Telmisartan", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IAHJkNFH2cKDX0FkwpBy1746103717.mp3", "video": ""}, {"text": "A 56-year-old male presents to the emergency department with severe headache, blurred vision, and chest pain. He reports a history of hypertension but admits to poor medication adherence. On examination, his blood pressure is 200/120 mmHg, and he appears diaphoretic and anxious. Which of the following drugs can be used to treat his condition?", "options": [{"label": "A", "text": "Lisinopril", "correct": false}, {"label": "B", "text": "Diltiazem", "correct": false}, {"label": "C", "text": "Losartan", "correct": false}, {"label": "D", "text": "Nicardipine", "correct": true}], "correct_answer": "D. Nicardipine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9da4BK37b5z5fwAn9NcQ1746103572.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Despite lifestyle modifications and treatment with metformin, his lipid profile remains suboptimal. The physician decides to initiate combination therapy with a statin and a fibrate to improve his lipid profile further. Which of the following best explains the mechanism of action of the fibrate in this patient?", "options": [{"label": "A", "text": "Inhibits HMG-CoA reductase", "correct": false}, {"label": "B", "text": "Activates peroxisome proliferator-activated receptor alpha (PPAR-α)", "correct": true}, {"label": "C", "text": "Binds to bile acids in the intestine", "correct": false}, {"label": "D", "text": "Inhibits lipolysis in adipose tissue", "correct": false}], "correct_answer": "B. Activates peroxisome proliferator-activated receptor alpha (PPAR-α)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/exujD6pmwZRCK29sr5Fk1736429877.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:731px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Statins / <span class=\"customMeta\" data-dictid=\"944fb955251692777189b1e05ebecf\">HMG</span> <span class=\"customMeta\" data-dictid=\"fdf03479ad16927771847526907130\">CoA</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> inhibitors</p>\n<p><strong>(Option A)</strong></p>\n<ul>\n<li>Atrovastatin</li>\n<li>Rosuvastatin</li>\n<li>Simvastatin</li>\n<li>Pitavastain</li>\n<li>Pravastatin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"944fb955251692777189b1e05ebecf\">HMG</span> <span class=\"customMeta\" data-dictid=\"fdf03479ad16927771847526907130\">CoA</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> ➜ <strong>￬</strong>cholesterol production in liver (<strong>￬</strong>LDL cholesterol)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fibrates / Activates PPAR-α <strong>(Option B)</strong></p>\n<ul>\n<li>Gemfibrozil</li>\n<li>Bezafibrate</li>\n<li>Fenofibrate</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activates PPAR-α ➜ <strong>￪</strong>expression of genes involved responsible for triglycerides <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> and <span class=\"customMeta\" data-dictid=\"0f5003332416927772029436c396b6\">VLDL</span> clearance.</p>\n<p>Fibrates can <strong>￬</strong>triglycerides and <strong>￪</strong>HDL cholesterol levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Resins / <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">Bile</span> acid sequestrants <strong>(Option C)</strong></p>\n<ul>\n<li>Cholestyramine</li>\n<li>Colesevelam</li>\n<li>Colestipol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sequestrates <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acids (<strong>￬</strong>recycling of <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acids from the <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> to the liver) ➜ To compensate this, the liver increases the conversion of cholesterol into <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acid ➜ <strong>￬</strong>in <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> cholesterol levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lipolysis inhibitor/Triglyceride <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> <strong>(Option D)</strong></p>\n<ul>\n<li>Niacin (Nicotinic acid)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"4a5c848a1e1692777191a2d5d303a0\">lipolysis</span> in <span class=\"customMeta\" data-dictid=\"5c2a4a949d16927771802ba54640cc\">adipose</span> tissue ➜ <strong>￬</strong>hepatic <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"0f5003332416927772029436c396b6\">VLDL</span> and <span class=\"customMeta\" data-dictid=\"4e4438ab5c16927771919ca536a59f\">LDL</span> ➜ <strong>￬</strong>LDL cholesterol and triglycerides in blood.</p>\n<p>Niacin also inhibits the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of <span class=\"customMeta\" data-dictid=\"5ceb81d29516927771884c732da32e\">HDL</span> ➜ <strong>￪</strong>HDL levels.</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:637px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HMG <span class=\"customMeta\" data-dictid=\"fdf03479ad16927771847526907130\">CoA</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> inhibitors/ Statins</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atrovastatin, Rosuvastatin, Simvastatin, Pitavastain, Pravastatin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activates <span class=\"customMeta\" data-dictid=\"c0d194cb5b16927771957905b7aad6\">peroxisome</span> proliferator-activated <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> (PPAR-α)/ Fibrates</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gemfibrozil, Bezafibrate, Fenofibrate</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bile acid sequestrants/ Resins</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cholestyramine, Colesevelam, Colestipol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lipolysis inhibitor/Triglyceride <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Niacin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NTyEWo97QdfD7smXb3oo1748086365.mp3", "video": ""}, {"text": "A 55-year-old male presents with complaints of fatigue and exertional chest discomfort. His medical history is significant for hypertension and a family history of coronary artery disease. Physical examination reveals elevated blood pressure and mild obesity. Laboratory investigations show elevated LDL cholesterol levels. Based on his risk factors and lab results, he is prescribed statin therapy. Which of the following effects may not be seen after the commencement of statin therapy?", "options": [{"label": "A", "text": "Antiplatelet action", "correct": false}, {"label": "B", "text": "Anticoagulant action", "correct": false}, {"label": "C", "text": "Increase in uric acid", "correct": true}, {"label": "D", "text": "Reduced CRP", "correct": false}], "correct_answer": "C. Increase in uric acid", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:593px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ <span class=\"customMeta\" data-dictid=\"4e4438ab5c16927771919ca536a59f\">LDL</span> cholesterol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit HMG-CoA <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> → ↓ cholesterol synthesis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ <span class=\"customMeta\" data-dictid=\"4df81a22571692777185a288d3c63d\">CRP</span> (C-reactive protein)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-inflammatory effect via <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"0ac01cc0c31692777185cae5f28175\">cytokine</span> production</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiplatelet action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Improve endothelial function and reduce <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> aggregation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> generation and <span class=\"customMeta\" data-dictid=\"a137b7092a16927772025412d4ef05\">fibrinogen</span> expression</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uric acid levels</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No consistent increase</strong>; some <span class=\"customMeta\" data-dictid=\"2d286fa70b1692777199aba0434a49\">statins</span> may slightly reduce it</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oSxqToz2soMyLKL0Xctn1747295206.mp3", "video": ""}, {"text": "Which of the following statin is metabolised by CYP3A4 enzyme?", "options": [{"label": "A", "text": "Fluvastatin", "correct": false}, {"label": "B", "text": "Rosuvastatin", "correct": false}, {"label": "C", "text": "Pravastatin", "correct": false}, {"label": "D", "text": "Atorvastatin", "correct": true}], "correct_answer": "D. Atorvastatin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:451px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Statin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP450 Metabolism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Enzyme Involved</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atorvastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP3A4</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Simvastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP3A4</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lovastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP3A4</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fluvastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP2C9</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rosuvastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal (10%)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2C9/CYP2C19 (minor)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pravastatin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No (non-CYP route)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excreted unchanged mostly</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ISiM6YmkyyWX3ern5dKO1747295324.mp3", "video": ""}, {"text": "A 58-year-old male on treatment for hyperlipidemia, hypertension, and CAD presents with severe muscle pain and weakness. He reports starting a new medication for a respiratory infection a few days ago. On examination, he appears distressed, with generalized muscle tenderness and weakness. Laboratory studies reveal markedly elevated serum creatine kinase (CK) levels, along with myoglobinuria. Which of the following medications is most likely responsible for this patient's presentation?", "options": [{"label": "A", "text": "Aspirin", "correct": false}, {"label": "B", "text": "Ramipril", "correct": false}, {"label": "C", "text": "Metformin", "correct": false}, {"label": "D", "text": "Clarithromycin", "correct": true}], "correct_answer": "D. Clarithromycin", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>imetidine.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G</strong>rapefruit juice (Furano coumarins).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>O</strong>meprazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>larithromycin &amp; <strong>C</strong>iprofloxacin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>K</strong>etoconazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong>cute alcoholism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>E</strong>rythromycin.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P</strong>rotease <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Ritonavir).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong>soniazid (inhibits all CYP enzymes except CYP2E1).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong>alproate.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lKxgUVG2tLXuvGD1VYPt1748086542.mp3", "video": ""}, {"text": "Which of the following statements is false?", "options": [{"label": "A", "text": "Aspirin is used to counteract flushing from niacin", "correct": false}, {"label": "B", "text": "Bile acid sequestrants can be used in pregnancy", "correct": false}, {"label": "C", "text": "Colesevelam is approved for use in T2DM", "correct": false}, {"label": "D", "text": "Niacin reduces uric acid levels", "correct": true}], "correct_answer": "D. Niacin reduces uric acid levels", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JDaFWjjS5rbJAucr5CHw1748086733.mp3", "video": ""}, {"text": "A 56-year-old male with a history of hyperlipidemia is being managed on a lipid-lowering therapy regimen. His current medications include atorvastatin for cholesterol management. During a follow-up visit, the patient's lipid profile indicates the need for additional triglyceride lowering, and the clinician considers adding a fibrate to his treatment plan. Which of the following fibrate drugs must be avoided in this patient?", "options": [{"label": "A", "text": "Fenofibrate", "correct": false}, {"label": "B", "text": "Clofibrate", "correct": false}, {"label": "C", "text": "Bezafibrate", "correct": false}, {"label": "D", "text": "Gemfibrozil", "correct": true}], "correct_answer": "D. Gemfibrozil", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:669px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gemfibrozil<br/>\n<strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gemfibrozil effectively lowers <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> TG levels by enhancing <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> and suppressing <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> synthesis.<br/>\n\t\t\t\tGemfibrozil appears to reduce <span class=\"customMeta\" data-dictid=\"0f5003332416927772029436c396b6\">VLDL</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> by the liver.</li>\n<li>Has CYP action, hence if combined with a <span class=\"customMeta\" data-dictid=\"389305b4521692777198497cf9c88b\">statin</span> increases the risk of myopathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bezafibrate<br/>\n<strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This second-generation <span class=\"customMeta\" data-dictid=\"20f07a2545169277720245254207a9\">fibric acid</span> <span class=\"customMeta\" data-dictid=\"0e2775093c169277718640a425c2a2\">derivative</span> is an alternative to <span class=\"customMeta\" data-dictid=\"c328d6e14f1692777188f13145f8da\">gemfibrozil</span> in mixed hyperlipidemias</li>\n<li>Has the least risk of myopathy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fenofibrate<br/>\n<strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This second-generation <span class=\"customMeta\" data-dictid=\"1c0d8a64fa1692777196f90166732c\">prodrug</span> <span class=\"customMeta\" data-dictid=\"20f07a2545169277720245254207a9\">fibric acid</span> <span class=\"customMeta\" data-dictid=\"0e2775093c169277718640a425c2a2\">derivative</span> raises <span class=\"customMeta\" data-dictid=\"f6e8ee3c7116927771880ab18a7d66\">HDL-C</span> and lowers <span class=\"customMeta\" data-dictid=\"fec284b7b316927771911abdb6eb5b\">LDL-C</span> more than other fibrates.</li>\n<li>most suitable fibrate for combining with <span class=\"customMeta\" data-dictid=\"2d286fa70b1692777199aba0434a49\">statins</span> because it minimally affects <span class=\"customMeta\" data-dictid=\"389305b4521692777198497cf9c88b\">statin</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> as it has no CYP action (less risk of myopathy).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clofibrate<br/>\n<strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clofibrate is an older fibrate and is less commonly used today.</li>\n<li>Associated with an increased risk of <span class=\"customMeta\" data-dictid=\"55d1a00d8c1692777188437e2069d4\">gallstone</span> formation.</li>\n<li>All <span class=\"customMeta\" data-dictid=\"5d9191602816927772024c1be6c6a0\">fibrates</span> in general increase the lithogenicity of bile.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Additional information</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clofibrate, bezafibrate, and <span class=\"customMeta\" data-dictid=\"9be9f32f6d169277720254a21ab9b4\">fenofibrate</span> may increase the effects of warfarin.</li>\n<li>Fibrates are C/I in pregnancy and children. <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">Hepatic</span> and <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> are relative contraindications.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>imetidine.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G</strong>rapefruit juice (Furano coumarins).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>O</strong>meprazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>larithromycin &amp; <strong>C</strong>iprofloxacin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>K</strong>etoconazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong>cute alcoholism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>E</strong>rythromycin.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P</strong>rotease <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Ritonavir).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong>soniazid (inhibits all CYP enzymes except CYP2E1).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong>alproate.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2G2HiX29sj6s2VJeXHMo1748086904.mp3", "video": ""}, {"text": "Match the following newer hypolipidemic drugs with their corresponding Mechanisms of Action (MOAs): Drug Mechanisms of Action 1. Ezetimibe A. Inhibition of cholesterol absorption in the intestines 2. Alirocumab B. Inhibition of PCSK9 enzyme 3. Lomitapide C. Inhibition of microsomal triglyceride transfer protein (MTP) 4. Bempedoic acid D. Inhibition of ATP citrate lyase", "options": [{"label": "A", "text": "1-A, 2-B, 3-C, 4-D", "correct": true}, {"label": "B", "text": "1-B, 2-A, 3-D, 4-C", "correct": false}, {"label": "C", "text": "1-C, 2-D, 3-B, 4-A", "correct": false}, {"label": "D", "text": "1-D, 2-B, 3-A, 4-C", "correct": false}], "correct_answer": "A. 1-A, 2-B, 3-C, 4-D", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:733px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ezetimibe</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disrupts cholesterol and <span class=\"customMeta\" data-dictid=\"fb2747c18d169277719515aee6cb10\">phytosterol</span> <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> in small intestines via PCIL1 <span class=\"customMeta\" data-dictid=\"850b296dd316927772005b651f6e87\">transporter</span> protein interference.</li>\n<li>Ezetimibe, with statins, enhances LDL-C reduction by inhibiting statin-induced cholesterol <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> rise.</li>\n<li>Primarily used with <span class=\"customMeta\" data-dictid=\"2d286fa70b1692777199aba0434a49\">statins</span> for primary hypercholesterolemia.</li>\n<li>Avoid combining with <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acid sequestrants due to inhibited <span class=\"customMeta\" data-dictid=\"0f3d0c8b6016927771870e397eb23e\">ezetimibe</span> absorption.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PCSK9 inhibitors </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>PCSK9 inhibitors: Monoclonal antibodies block PCSK9 action, promoting LDL <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> recycling and degradation, enhancing LDL clearance.</li>\n<li>Alirocumab and evolocumab: Lower LDL-C in <span class=\"customMeta\" data-dictid=\"5dda3cc2ab1692777202b3b3c65bea\">familial</span> <span class=\"customMeta\" data-dictid=\"29827400541692777189ca4d3ba143\">hypercholesterolemia</span> or <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> disease,given subcutaneously every 2 weeks or monthly, <span class=\"customMeta\" data-dictid=\"f0ff39a3fa1692777184cf743ca1e7\">complement</span> <span class=\"customMeta\" data-dictid=\"2d286fa70b1692777199aba0434a49\">statins</span> to reduce LDL-C.</li>\n<li>Inclisiran, a new drug which is a <span class=\"customMeta\" data-dictid=\"c83e76c8511692777198089a720108\">silencing</span> RNA.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lomitapide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>An <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> of microsomal <span class=\"customMeta\" data-dictid=\"482f0bd5841692777200af07c2766c\">triglyceride</span> transfer protein (MTP).</li>\n<li>Action on MTP hinders the production of VLDLs in liver cells and chylomicrons in the intestinal epithelial cells.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Omega 3 <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Present in fish</li>\n<li>Deacreses FFA delivery to liver and decreases activity of TG synthesizing enzymes.</li>\n<li>Decrease VLDL production in liver</li>\n<li>Drugs: Eicosa <span class=\"customMeta\" data-dictid=\"f8e9a2a10f16927771955bd1d3c5b2\">penta</span> enoic acid (Icosapent), Docosa hexa enoic acid</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bempedoic acid </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A prodrug, transforms into its active state, bempedoic acid-CoA which competitively blocks ATP Citrate Lyase, diminishing the production of <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> cholesterol <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> by limiting the flow of acetyl-CoA to HMG-CoA reductase.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AAIEXA13WT19cUZcmmNG1745662328.mp3", "video": ""}, {"text": "Match the following Antiarrhythmic Drugs with their Mechanisms of Action: Antiarrhythmic Drugs Mechanisms of Action 1. Propranolol A. Beta-adrenergic receptor blocker (Class II) 2. Procainamide B. Sodium channel blocker (Class I) 3. Sotalol C. Potassium channel blocker (Class III) 4.Verapamil D. Calcium channel blocker (Class IV)", "options": [{"label": "A", "text": "1-A, 2-B, 3-C, 4-D", "correct": true}, {"label": "B", "text": "1-B, 2-A, 3-C, 4-D", "correct": false}, {"label": "C", "text": "1-C, 2-B, 3-A, 4-D", "correct": false}, {"label": "D", "text": "1-D, 2-B, 3-A, 4-C", "correct": false}], "correct_answer": "A. 1-A, 2-B, 3-C, 4-D", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/RlgKJ4CYPfW9XMcjhG6J1736430640.png", "https://image.prepladder.com/content/IZLHlga9zAEOncEHWfbP1736430691.png", "https://image.prepladder.com/content/1S0a0R3ZCZvRZieOVISf1736430749.png", "https://image.prepladder.com/content/5xhqU4waUq5Sz89Bu12g1736430794.png", "https://image.prepladder.com/content/5VcczplZYi3u2L9mudMW1736431001.png", "https://image.prepladder.com/content/hZh65o0j25CNnfPF6h871736430901.png", "https://image.prepladder.com/content/0rYftD1X4mzwQdJcqTBj1736431194.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:659px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sodium channel blockers (Class 1) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1A</p>\n<ul>\n<li>Quinidine</li>\n<li>Procainamide</li>\n<li>Disopyramide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks sodium channels (Na+) during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential.</p>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1026\" src=\"https://image.prepladder.com/content/RlgKJ4CYPfW9XMcjhG6J1736430640.png\" width=\"2392\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1B</p>\n<ul>\n<li>Lidocaine</li>\n<li>Mexiletine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks sodium channels (Na+) during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential, but with fast dissociation.</p>\n<img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1069\" src=\"https://image.prepladder.com/content/IZLHlga9zAEOncEHWfbP1736430691.png\" width=\"2481\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1C</p>\n<ul>\n<li>Flecainide</li>\n<li>Propafenone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potent <span class=\"customMeta\" data-dictid=\"276be2047116927771989f7bf5ed02\">sodium channel</span> blockers (Na+) with slow <span class=\"customMeta\" data-dictid=\"18fb34ab321692777186e9bc95a726\">dissociation</span> from the channel. </p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1069\" src=\"https://image.prepladder.com/content/1S0a0R3ZCZvRZieOVISf1736430749.png\" width=\"2481\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta blockers (Class 2)</strong></p>\n<ul>\n<li>Propranolol</li>\n<li>Metoprolol</li>\n<li>Esmolol</li>\n<li>Carvedilol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decrease SA and AV nodal activity by ↓ cAMP thereby ↓ Ca currents.</p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1447\" src=\"https://image.prepladder.com/content/5xhqU4waUq5Sz89Bu12g1736430794.png\" width=\"2583\"/></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potassium channel blockers (Class 3)</strong></p>\n<ul>\n<li>Amiodarone</li>\n<li>Ibulitide</li>\n<li>Dofetilide</li>\n<li>Sotalol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Delays repolarization, lengthens the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential, and increases the <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> period.</p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1976\" src=\"https://image.prepladder.com/content/5VcczplZYi3u2L9mudMW1736431001.png\" width=\"2375\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcium channel blockers (Class 4)</strong></p>\n<ul>\n<li>Diltiazem</li>\n<li>Verapamil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reducing <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> influx during <span class=\"customMeta\" data-dictid=\"b0fcf93d611692777195e97ec23460\">phase 2</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> and decreases myocardial contractility, heart rate, and AV nodal <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> velocity.</p>\n<img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1150\" src=\"https://image.prepladder.com/content/hZh65o0j25CNnfPF6h871736430901.png\" width=\"2219\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Miscellaneous drugs (Class 5)</strong></p>\n<ul>\n<li>Atropine</li>\n<li>Adenosine</li>\n<li>Digoxin</li>\n<li>Magnesium sulfate</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Atropine: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> in bradyarrhythmias</li>\n<li>Adenosine: used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attack of <span class=\"customMeta\" data-dictid=\"cd15fe58221692777194fbb9eec8d1\">paroxysmal</span> <span class=\"customMeta\" data-dictid=\"619efd9f7b169277719928c9441919\">supraventricular</span> <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> and to treat <span class=\"customMeta\" data-dictid=\"b9ebf200411692777199f24bffc7a8\">supra</span> <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> in <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> patients</li>\n<li>Digoxin: Treat atrial flutter/fibrillation</li>\n<li>Magnesium sulfate: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> in Torsades <span class=\"customMeta\" data-dictid=\"233d458dd316927771854358419c86\">de</span> pointes</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KRXCSsXqiddRQnzO8IyO1748194741.mp3", "video": ""}, {"text": "Which of the following Class 1 antiarrhythmic drugs have an indirect effect of opening Inward rectifier potassium (K+) channels?", "options": [{"label": "A", "text": "Quinidine", "correct": false}, {"label": "B", "text": "Lidocaine", "correct": true}, {"label": "C", "text": "Flecainide", "correct": false}, {"label": "D", "text": "Propafenone", "correct": false}], "correct_answer": "B. Lidocaine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/i3wwHoFmW0gQGXm3Nw3P1736431380.png", "https://image.prepladder.com/content/cFcmkbNZ6L29CkrSLmA81736431421.png", "https://image.prepladder.com/content/69bh5t4z88AhiNhdTmYQ1736431457.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:703px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sodium channel blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1A:</p>\n<ul>\n<li>Quinidine (Option A)</li>\n<li>Procainamide</li>\n<li>Disopyramide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blocks Na+ channels during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> (AP)</li>\n<li>↑AP duration</li>\n<li>Closes inward <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels </li>\n</ul>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1026\" src=\"https://image.prepladder.com/content/i3wwHoFmW0gQGXm3Nw3P1736431380.png\" width=\"2392\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses: </strong>Ventricular and atrial tachycardia</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1B:</p>\n<ul>\n<li>Lidocaine (Option B)</li>\n<li>Mexiletine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blocks Na+ channels during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> AP, but with fast dissociation</li>\n<li>↓AP duration</li>\n<li>Opens inward <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels</li>\n</ul>\n<p> </p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1069\" src=\"https://image.prepladder.com/content/cFcmkbNZ6L29CkrSLmA81736431421.png\" width=\"2481\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses:</strong> Only <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> tachycardia</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Class 1C:</p>\n<ul>\n<li>Flecainide (Option C)</li>\n<li>Propafenone (Option D)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Potent Na+ channel blockers with slow <span class=\"customMeta\" data-dictid=\"18fb34ab321692777186e9bc95a726\">dissociation</span> from the channel</li>\n<li>No effect on <span class=\"customMeta\" data-dictid=\"603878db1116927771812fecb63aec\">AP</span> duration and inward <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels</li>\n</ul>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1069\" src=\"https://image.prepladder.com/content/69bh5t4z88AhiNhdTmYQ1736431457.png\" width=\"2481\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses: </strong>Resistant cases of <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> and atrial tachycardia</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:538px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase 0 depression</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Repolarization</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Action potential duration</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prolonged</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IB</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Weak</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Shortened</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreased</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IC</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Strong</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No effect</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/A8JvQoTREHAFJb9CtxZx1748804832.mp3", "video": ""}, {"text": "A 35-year-old man presents to the emergency department with palpitations and dizziness. His electrocardiogram (ECG) reveals a narrow, complex tachycardia with a rate of 200 beats per minute. The patient's history is significant for episodes of palpitations and syncope. On physical examination, his blood pressure is 110/70 mmHg, and he is diaphoretic but alert. A further review of his ECG shows a short PR interval and a delta wave. Which of the following is the most appropriate drug of choice to treat this patient?", "options": [{"label": "A", "text": "Lidocaine", "correct": false}, {"label": "B", "text": "Esmolol", "correct": false}, {"label": "C", "text": "Procainamide", "correct": true}, {"label": "D", "text": "Ajmaline", "correct": false}], "correct_answer": "C. Procainamide", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/hBLNSaDihEs1JKsCnFl51736431625.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/c3VWAqKkoRv67NJV2dQf1748804685.mp3", "video": ""}, {"text": "A 65-year-old patient with a history of hypertension and coronary artery disease presents to the emergency department with palpitations and shortness of breath. An ECG confirms atrial fibrillation with a rapid ventricular rate. A drug is administered to control the ventricular rate in this patient. Which of the following is not an AV nodal blocking drug?", "options": [{"label": "A", "text": "Adenosine", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Metoprolol", "correct": false}, {"label": "D", "text": "Digoxin", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:680px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adenosine </strong><br/>\n\t\t\t(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Administered as a rapid IV bolus.</li>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"a35c217ec416927772009a7f3b20f4\">termination</span> of reentrant <span class=\"customMeta\" data-dictid=\"619efd9f7b169277719928c9441919\">supraventricular</span> arrhythmias.</li>\n<li><strong>￪</strong>AV nodal refractoriness, interrupting reentrant circuits relying on the AV node.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta Blockers </strong>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibit <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> effects contributing to arrhythmias.</li>\n<li><strong>￬</strong>HR and <strong>￬</strong>intracellular Ca2+ overload, inhibiting afterdepolarization-mediated automaticity.</li>\n<li><strong>￪</strong>AV nodal refractoriness, useful in terminating reentrant arrhythmias involving the AV node.</li>\n<li>Control <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> response in <span class=\"customMeta\" data-dictid=\"e6a04221a41692777182825f0f08da\">atrial fibrillation</span> or atrial flutter.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcium Channel Blockers - Verapamil, Diltiazem </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Block Ca2+ channels in <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> cells.</li>\n<li><strong>￬</strong>AV nodal <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> <span class=\"customMeta\" data-dictid=\"12c4510e191692777201c23ec126a3\">velocity</span> and <strong>￪</strong>AV nodal refractoriness.</li>\n<li>Treat reentrant arrhythmias involving the AV node.</li>\n<li>Approved for temporary control of rapid <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> rate in <span class=\"customMeta\" data-dictid=\"263d7b97a11692777182150b1d2092\">atrial flutter</span> or AF and rapid conversion of <span class=\"customMeta\" data-dictid=\"b81f50b4751692777196935ca5090b\">PSVT</span> to <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> rhythm.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Digoxin (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>￪</strong>AV nodal refractoriness.</li>\n<li>Useful in terminating reentrant arrhythmias involving the AV node.</li>\n<li>Controls <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> response in patients with AF.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5Wo48dTgFoWykgS8dxaR1748804497.mp3", "video": ""}, {"text": "A 42-year-old man is brought to the ED by his wife after fainting, with recent episodes of dizziness and palpitations.His history includes hypertension and atrial fibrillation, for which he was recently started on a new medication. His vital signs are blood pressure: 100/60 mmHg , heart rate: 140 bpm. An ECG is obtained and shows the following pattern: Based on the clinical presentation and the ECG, which of the following interventions is most appropriate for the initial management of this patient?", "options": [{"label": "A", "text": "Administer intravenous amiodarone", "correct": false}, {"label": "B", "text": "Administer intravenous adenosine", "correct": false}, {"label": "C", "text": "Administer intravenous magnesium sulfate", "correct": true}, {"label": "D", "text": "Perform synchronised cardioversion", "correct": false}], "correct_answer": "C. Administer intravenous magnesium sulfate", "question_images": ["https://image.prepladder.com/content/87p2p4rCvap5uASyFSdA1736431982.png"], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs causing QT prolongation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Cardioactive drugs</strong></p>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top; width:50%\">\n<p style=\"text-align:center\"><strong>Non-cardioactive drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Quinidine</li>\n<li>Sotalol</li>\n<li>Procainamide</li>\n<li>Disopyramide</li>\n<li>Dofetilide</li>\n<li>Ibutilide</li>\n<li>Amiodarone</li>\n</ul>\n</td>\n<td style=\"border-color:#000000; border-style:solid; border-width:1px; vertical-align:top; width:50%\">\n<ul>\n<li>Fluoroquinolones and Macrolides</li>\n<li>Astemizole and <span class=\"customMeta\" data-dictid=\"9eabc8024b1692777200e1ab08a249\">Terfenadine</span> (Antihistamines)</li>\n<li>Bedaquiline (anti-tuberculosis drug)</li>\n<li>Cisapride (drug for constipation)</li>\n<li>Tricyclic antidepressants and SSRI</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/c1y0BQ4nBFQVB5lYQ5tQ1748804294.mp3", "video": ""}, {"text": "A 60-year-old woman presents to her primary care physician with complaints of fatigue, weight gain, and cold intolerance over the past few months. She has a history of atrial fibrillation and has been on amiodarone for the past year. On examination, she has a diffusely enlarged thyroid gland with no palpable nodules. Which of the following mechanisms best explains how amiodarone can cause thyroid dysfunction in this patient?", "options": [{"label": "A", "text": "Stimulation of thyroid hormone synthesis", "correct": false}, {"label": "B", "text": "Inhibition of thyroid hormone synthesis", "correct": true}, {"label": "C", "text": "Increased thyroid hormone release", "correct": false}, {"label": "D", "text": "Suppression of thyroid-stimulating hormone (TSH) secretion", "correct": false}], "correct_answer": "B. Inhibition of thyroid hormone synthesis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PbmkylJd4FVA6p4QbNkw1748804034.mp3", "video": ""}, {"text": "A 35-year-old woman presents to the emergency department with sudden palpitations and lightheadedness. She has a previous history of MI and her medications include a beta blocker. On examination, her heart rate is 180 bpm, regular, and she appears anxious. An ECG shows a narrow complex tachycardia consistent with paroxysmal supraventricular tachycardia (PSVT). What is the most appropriate next step in the management of this patient's PSVT?", "options": [{"label": "A", "text": "Intravenous verapamil", "correct": false}, {"label": "B", "text": "Intravenous adenosine", "correct": true}, {"label": "C", "text": "Intravenous amiodarone", "correct": false}, {"label": "D", "text": "Intravenous vernakalant", "correct": false}], "correct_answer": "B. Intravenous adenosine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:787px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adenosine </strong>(Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Verapamil </strong>(Option A)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Efficacy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Equivalent to or better than verapamil for terminating PSVT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effective for terminating PSVT</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Short-acting (&lt; 1 minute)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Longer-acting than adenosine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Transient and generally mild (e.g., dyspnea, chest pain, flushing, hypotension, <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrest)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C/I in patients with hypotension, CHF, or those receiving beta-blockers</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Safety</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe in patients with wide QRS tachycardia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C/I in patients with wide QRS tachycardia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other Considerations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Requires rapid i.v injection, not suitable for <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> PSVT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can be used for <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> PSVT</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use in Asthma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can <span class=\"customMeta\" data-dictid=\"eba5ba77ec169277719688fab52fb0\">precipitate</span> bronchospasm, making verapamil the preferred choice for these patients</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC for <span class=\"customMeta\" data-dictid=\"b81f50b4751692777196935ca5090b\">PSVT</span> in asthmatic patients</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pU93nE8kK3AhpujN5Xr91748803851.mp3", "video": ""}, {"text": "Match the following drug toxicities with their appropriate antidotes. Drug toxicity Antidote A. Lignocaine B. Amiodarone C. Verapamil D. Beta blockers 1. 20% Intralipid 2. IV Calcium gluconate 3. Glucagon hormone", "options": [{"label": "A", "text": "A-1,B-2,C-3,D-2", "correct": false}, {"label": "B", "text": "A-2,B-3,C-2,D-1", "correct": false}, {"label": "C", "text": "A-1,B-1,C-2,D-3", "correct": true}, {"label": "D", "text": "A-2,B-3.C-3,D-1", "correct": false}], "correct_answer": "C. A-1,B-1,C-2,D-3", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:725px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Antidote</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of antidote</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Verapamil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IV <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> gluconate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Raises blood <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels, facilitating <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> entry to restore normal heart function and blood pressure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amiodarone</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20% Intralipid</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Creates an enlarged <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> phase, causing toxic drugs to move from tissue to plasma, reducing drug concentration in <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> tissue ➜ Enhances <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> conduction, contractility, and <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> perfusion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lignocaine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta-blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagon hormone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bypasses β-receptors by acting on <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">glucagon</span> receptors to enhance <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> and AV conduction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/A4iTiGoWbq83yxvv09dM1748803687.mp3", "video": ""}, {"text": "Which of the following is the drug of choice for treating ventricular tachyarrhythmias induced by digoxin toxicity?", "options": [{"label": "A", "text": "Amiodarone", "correct": false}, {"label": "B", "text": "Lidocaine", "correct": true}, {"label": "C", "text": "Procainamide", "correct": false}, {"label": "D", "text": "Verapamil", "correct": false}], "correct_answer": "B. Lidocaine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Vi0Dvg6Kq0GVjbBlKsKe1748803531.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 26 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following statements regarding the mechanism of action of Digoxin is incorrect?", "options": [{"label": "A", "text": "Digoxin inhibits the Na⁺-K⁺ ATPase pump, leading to an increase in intracellular sodium concentration.", "correct": false}, {"label": "B", "text": "Increased intracellular Ca²⁺ concentration due to Digoxin leads to enhanced myocardial contractility.", "correct": false}, {"label": "C", "text": "Digoxin prolongs the (AV) node's refractory period, slowing conduction.", "correct": false}, {"label": "D", "text": "Digoxin decreases vagal tone, resulting in increased heart rate.", "correct": true}], "correct_answer": "D. Digoxin decreases vagal tone, resulting in increased heart rate.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/eZFTFVnXhaq9qbjlZVSr1736439254.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin ⟶<strong> <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of Na⁺-K⁺ATPase Pump </strong>⟶ <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">Intracellular</span> Na⁺ Accumulation ⟶ <strong>Intracellular Ca²⁺ Increase</strong> ⟶ Enhanced Myocardial <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">Contractility</span> ⟶ Positive <span class=\"customMeta\" data-dictid=\"d44f29df6116927771902150f69464\">Inotropic</span> Effect ⟶ Increased <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">Cardiac</span> Output ⟶ Treatment of Heart Failure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vagotonic effect</strong> ⟶<strong> Increased parasympathetic/vagal tone </strong>⟶ <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">Blocking</span> both S.A and A.V <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> ⟶ <strong>Prolongation of <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">Refractory</span> Period ⟶ Slowing of <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">Conduction</span> Through AV Node</strong> ⟶ Control of Rate in Arrhythmias</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GdaaZivLvwAybI3C5huo1748084516.mp3", "video": ""}, {"text": "A 58-year-old male patient presents with severe chest pain, radiating to his left arm and jaw. An electrocardiogram (ECG) confirms ST-segment elevation myocardial infarction (STEMI). The cardiologist recommends an urgent percutaneous coronary intervention (PCI) with the placement of an endovascular stent to restore blood flow to the affected coronary artery. What is the drug composition commonly used in drug-eluting endovascular stents?", "options": [{"label": "A", "text": "Prasugrel", "correct": false}, {"label": "B", "text": "Sirolimus", "correct": true}, {"label": "C", "text": "Heparin", "correct": false}, {"label": "D", "text": "Clopidogrel", "correct": false}], "correct_answer": "B. Sirolimus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DlNFJdHZ6kfB4HJgLIuE1748086174.mp3", "video": ""}, {"text": "A 65-year-old male presents with severe substernal chest pain radiating to his arm and back. ECG showed sinus rhythm with small Q waves in leads III and aVF, T-wave inversions in leads II and III, and aVF and ST depressions in V5 and V6. His vitals are normal. Cardiac markers are elevated. This patient can receive all of the following except?", "options": [{"label": "A", "text": "Ramipril", "correct": false}, {"label": "B", "text": "Ticagrelor", "correct": false}, {"label": "C", "text": "Streptokinase", "correct": true}, {"label": "D", "text": "Enoxaparin", "correct": false}], "correct_answer": "C. Streptokinase", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BBSPdVZLLZ6oKqgKAzZO1748085955.mp3", "video": ""}, {"text": "A 55-year-old male with a history of hypertension presents with increasing shortness of breath, fatigue, and swelling in his legs. On examination, he has elevated jugular venous pressure, bilateral pitting edema, and pulmonary crackles. Echocardiography reveals reduced ejection fraction. A new medication was recently started to manage his condition, but he developed severe angioedema, leading to the discontinuation of the drug. Identify the drug?", "options": [{"label": "A", "text": "Sacubitril/Valsartan", "correct": false}, {"label": "B", "text": "Ivabradine", "correct": false}, {"label": "C", "text": "Omapatrilat", "correct": true}, {"label": "D", "text": "Dapagliflozin", "correct": false}], "correct_answer": "C. Omapatrilat", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Omapatrilat ⟶ <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of Neprilysin and Angiotensin-Converting Enzyme (ACE) ⟶ Decreased Degradation of Natriuretic Peptides and <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">Inhibition</span> of Angiotensin II Production ⟶ Increased Levels of Natriuretic Peptides and Decreased Vasoconstriction ⟶ <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">Vasodilation</span> and Decreased Blood Pressure ⟶ Decreased Cardiac Afterload ⟶ Improved Cardiac Output ⟶ Treatment of Heart Failure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily for the treatment of <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> and heart failure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Angioedema</li>\n<li>Hypotension</li>\n<li>Cough</li>\n<li>Dizziness</li>\n<li>Fatigue</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sacubitril/Valsartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ARNI (Angiotensin Receptor-Neprilysin Inhibitor)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure with <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction (HFrEF).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypotension</li>\n<li>Hyperkalemia</li>\n<li>Renal impairment</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ivabradine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Funny channel (I Na+) inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure with <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction (HFrEF) in patients with resting heart rate ≥ 70 bpm on maximally tolerated beta-blockers.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bradycardia</li>\n<li>Hypertension</li>\n<li>Atrial fibrillation</li>\n<li>Luminous phenomena (visual brightness)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vericiguat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Soluble <span class=\"customMeta\" data-dictid=\"deb73df780169277718873138a593e\">guanylate</span> <span class=\"customMeta\" data-dictid=\"b638747a661692777185a6182d6e5f\">cyclase</span> (sGC) stimulator</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> with <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction (HFrEF).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypotension</li>\n<li>Anemia</li>\n<li>Dizziness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dapagliflozin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>SGLT2 inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure with <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"3b69bda4d21692777187109c85a27e\">ejection</span> fraction (HFrEF).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infections</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old female patient with a history of chronic heart failure and atrial fibrillation is being treated with digoxin. Recently, she has been prescribed additional medications for comorbid conditions. She presents to the emergency department with symptoms of nausea, vomiting, confusion and visual disturbances. Her serum digoxin level is found to be elevated. Which of the following medications is most likely to have precipitated digoxin toxicity in this patient?", "options": [{"label": "A", "text": "Furosemide", "correct": true}, {"label": "B", "text": "St. John's Wort", "correct": false}, {"label": "C", "text": "Cholestyramine", "correct": false}, {"label": "D", "text": "Rifampin", "correct": false}], "correct_answer": "A. Furosemide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug interactions of digoxin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Explanation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diuretics (e.g., Furosemide,Hydrochlorothiazide)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increased risk of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> due to <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> <span class=\"customMeta\" data-dictid=\"2cc844bc9c1692777189739abf1dc5\">imbalance</span> (hypokalemia).</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ARBs and <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> Inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can increase <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by reducing its <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> clearance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Beta-blockers (e.g., Metoprolol)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can increase the risk of <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> and heart block.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macrolide Antibiotics (e.g., Clarithromycin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can increase <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by inhibiting its metabolism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Quinidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by inhibiting its <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> clearance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Herbal Supplements (e.g., St. John's Wort)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>It can decrease <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by inducing its metabolism.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cholestyramine and Antacids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>It can reduce <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> in the gut, leading to decreased efficacy.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P-gp Inducers (e.g., Rifampin)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>It can decrease <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by increasing its efflux from enterocytes and hepatocytes.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>P-gp Inhibitors (e.g., Verapamil, Amiodarone)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can increase <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels by inhibiting its efflux from enterocytes and hepatocytes.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reason for Contraindication</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> arrhythmias</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin can exacerbate these conditions.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases the risk of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypercalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases the risk of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypomagnesemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases the risk of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin is excreted by the kidneys; impaired function can lead to toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute myocardial infarction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin may increase oxygen demand and worsen myocardial damage.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertrophic obstructive cardiomyopathy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin can increase outflow obstruction.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>WPW (Wolff-Parkinson-White) syndrome with atrial fibrillation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can increase <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> rate.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reason for Contraindication</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amiodarone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Quinidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spironolactone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can increase <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diuretics (loop and thiazide)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can cause <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> disturbances, increasing <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> risk.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Succinylcholine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can increase the risk of arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sympathomimetics (e.g., epinephrine, norepinephrine)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can increase the risk of arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium channel blockers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can decrease <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> <span class=\"customMeta\" data-dictid=\"3a3fb1b8a816927771840e6a344cc0\">clearance</span> and increase <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> risk.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wgYVZKB3IrJuNu3eHBbd1748085485.mp3", "video": ""}, {"text": "Which ECG changes would not be seen in digoxin toxicity?", "options": [{"label": "A", "text": "Increased PR Interval", "correct": false}, {"label": "B", "text": "Widened QRS", "correct": true}, {"label": "C", "text": "Narrow QRS Complex", "correct": false}, {"label": "D", "text": "Inverted T Wave", "correct": false}], "correct_answer": "B. Widened QRS", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ys9eUJxajrWqLl4z9fkA1736440006.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ECG Changes with Digoxin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>•<strong> ↑ PR Interval → <span class=\"customMeta\" data-dictid=\"93722e23b31692777182e48d478f12\">AV node</span> block</strong></p>\n<p><strong>•</strong> ↑ RR Interval → SA <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> block</p>\n<p><strong>• Narrow QRS→ Tells about <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> depolarisation - ↑ <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> sodium</strong></p>\n<p>•<strong> Inverted T wave→↓ <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> potassium</strong></p>\n<p>• Reverse <span class=\"customMeta\" data-dictid=\"63b7807cc41692777200fab227369f\">tick</span> sign/ Salvador dali sign (Characteristic of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> toxicity)</p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1634\" src=\"https://image.prepladder.com/content/ys9eUJxajrWqLl4z9fkA1736440006.png\" width=\"2396\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KlO2gaqXglPFGbyXCwer1748085127.mp3", "video": ""}, {"text": "A 72-year-old female with a history of CHF presents to the emergency department with nausea, vomiting, and visual disturbances. Her ECG reveals a sinus bradycardia with PR interval prolongation, inverted T waves and a particular finding below. Laboratory investigations show elevated serum digoxin levels. Which of the following drugs should not be used in the treatment of drug toxicity for this patient?", "options": [{"label": "A", "text": "Nifedipine", "correct": true}, {"label": "B", "text": "Digibind", "correct": false}, {"label": "C", "text": "Lidocaine", "correct": false}, {"label": "D", "text": "KCL", "correct": false}], "correct_answer": "A. Nifedipine", "question_images": ["https://image.prepladder.com/content/hEuFp64eGucpn4ezzAND1736439839.png"], "explanation_images": ["https://image.prepladder.com/content/l4RZLs6iiAZZKf4TxXSK1736439950.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features Of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">Digoxin</span> Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Arrhythmias (e.g., atrial fibrillation, <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> tachycardia)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Lidocaine</strong></li>\n<li>Propranolol (for <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> arrhythmias)</li>\n<li><strong>Digibind (if refractory)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperkalemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Insulin-glucose therapy</li>\n<li>Potassium-lowering agents(Calcium gluconate)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Potassium supplementation(KCL)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bradycardia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atropine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neurological symptoms (e.g., confusion, delirium)</p>\n</td>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Supportive care</li>\n<li>Correction of <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> imbalances.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p>Investigations for <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">Digoxin</span> Toxicity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Serum <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">Digoxin</span> levels</strong></li>\n<li>Electrolyte levels (potassium, calcium)</li>\n<li><strong>ECG Changes with Digoxin</strong></li>\n</ul>\n<ul>\n<li><strong>↑ PR Interval → <span class=\"customMeta\" data-dictid=\"93722e23b31692777182e48d478f12\">AV node</span> block</strong></li>\n<li>↑ RR Interval → SA <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">node</span> block</li>\n<li>Narrow QRS→ Tells about <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> depolarisation - ↑ <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> sodium</li>\n<li><strong>Inverted T wave→↓ <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> potassium</strong></li>\n<li><strong>Reverse <span class=\"customMeta\" data-dictid=\"63b7807cc41692777200fab227369f\">tick</span> sign/ Salvador dali sign - Characteristic of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> toxicity</strong></li>\n</ul>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1634\" src=\"https://image.prepladder.com/content/l4RZLs6iiAZZKf4TxXSK1736439950.png\" width=\"2396\"/></p>\n<ul>\n<li>Renal function tests</li>\n<li>Serum digoxin-specific <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> test (if <span class=\"customMeta\" data-dictid=\"d3323d4b271692777200122ea879e5\">toxicity</span> suspected)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antidote</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin-specific <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> fragments (<strong>Digibind)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MaSUo5JfO66TOG2Tvqcg1748085022.mp3", "video": ""}, {"text": "A 68-year-old male presents to the clinic with worsening dyspnea on exertion, fatigue, and ankle swelling. He has a past medical history of chronic heart failure, which was diagnosed 5 years ago. Despite being on several medications, he continues to experience symptoms. On examination, his heart rate is irregular and there is evidence of jugular venous distension. What is the drug of choice for managing his condition?", "options": [{"label": "A", "text": "Lisinopril", "correct": false}, {"label": "B", "text": "Carvedilol", "correct": false}, {"label": "C", "text": "Furosemide", "correct": false}, {"label": "D", "text": "Digoxin", "correct": true}], "correct_answer": "D. Digoxin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EbSd2A9k39ACxvhtaIWl1748084854.mp3", "video": ""}, {"text": "All of the following statements regarding the pharmacokinetics of digoxin are true except?", "options": [{"label": "A", "text": "Half-life 36 to 48 hours", "correct": false}, {"label": "B", "text": "Narrow therapeutic index", "correct": false}, {"label": "C", "text": "Digoxin is primarily excreted unchanged by the kidney.", "correct": false}, {"label": "D", "text": "Digoxin is concentrated in the plasma more than in the heart.", "correct": true}], "correct_answer": "D. Digoxin is concentrated in the plasma more than in the heart.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Absorption:</strong> Well-absorbed orally.</li>\n<li><strong>Distribution:</strong>\n<ul>\n<li>Large volume of distribution.</li>\n<li><strong>Concentrated in the heart to a greater extent than in plasma, approximately 20 times higher.</strong></li>\n<li>Crosses the <span class=\"customMeta\" data-dictid=\"d89cb634601692777183adec401a59\">blood-brain barrier</span> and placenta.</li>\n<li><strong>Metabolism:</strong> Primarily Hepatic, <strong>half-life 36 to 48 hours.</strong></li>\n</ul>\n</li>\n<li><strong>Excretion</strong>: <strong>Renal, with 70-80% of the administered dose excreted unchanged in the urine.</strong></li>\n<li><strong>Narrow <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">Therapeutic</span> index</strong></li>\n<li><strong>Nonlinear <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> </strong>(Clearance and <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">Half-life</span> can vary with changes in dosage)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/O6rRC3CDoZNBZQIgalN21748084697.mp3", "video": ""}, {"text": "A patient presents with left-sided chest pain, which started 5 hours ago, radiating to the left arm and doesn’t get relieved on taking rest. An ECG is taken immediately which is given below. Which of the following is the drug for definitive management in this patient?", "options": [{"label": "A", "text": "Nitroglycerin", "correct": false}, {"label": "B", "text": "Reteplase", "correct": true}, {"label": "C", "text": "Aspirin &amp;amp; ticagrelor", "correct": false}, {"label": "D", "text": "Morphine", "correct": false}], "correct_answer": "B. Reteplase", "question_images": ["https://image.prepladder.com/content/YCzObGvEkZ88eUxQCzci1736438942.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oxygen</li>\n<li>Nitrates</li>\n<li>Morphine</li>\n<li>Loading lose (dual antiplatelets + statin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definitive management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reperfusion therapy:</p>\n<ul>\n<li>Primary <span class=\"customMeta\" data-dictid=\"b2fb1a3a5416927771953ea4fa15e1\">percutaneous</span> <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> intervention: If presents within 12 hours.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p style=\"text-align: center;\">(door to balloon time &lt;90 minutes)</p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Thrombolysis: If presents more than 12 hours or no access to PCI within 2 hours of presentation.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Recombinant tissue <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> activators: alteplase, <span class=\"customMeta\" data-dictid=\"c11317576e16927771975d73bfd9cb\">reteplase</span> and tenecteplase.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p style=\"text-align: center;\">(door to needle time &lt;30 minutes)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Long-term management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lifestyle modifications</li>\n<li>Dual antiplatelets</li>\n<li>ACE inhibitors</li>\n<li>Beta-blockers</li>\n<li>Statins</li>\n<li>Oral hypoglycemics (if diabetic)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HEktxoCmw4v2l3L9D0PJ1748081236.mp3", "video": ""}, {"text": "A 68-year-old male patient with a history of chronic heart failure has been experiencing worsening symptoms despite being on optimal medical therapy, including ACE inhibitors, beta-blockers, and diuretics. His cardiologist decides to add a cardiac glycoside to his treatment regimen to improve his symptoms. Which of the following medications is NOT a cardiac glycoside?", "options": [{"label": "A", "text": "Doxorubicin", "correct": true}, {"label": "B", "text": "Digitoxin", "correct": false}, {"label": "C", "text": "Digoxin", "correct": false}, {"label": "D", "text": "Ouabain", "correct": false}], "correct_answer": "A. Doxorubicin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiac glycoside</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Source</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digitalis lanata (foxglove plant)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digitoxin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digitalis purpurea (foxglove plant)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ouabain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Strophanthus gratus (African plant)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lanatoside C</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digitalis lanata</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetyldigitoxin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Synthetic derivative</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bufalin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bufo gargarizans (Chinese toad)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/iVcYyRpnBHZuxwOzVpBY1748084300.mp3", "video": ""}, {"text": "Which of the following is a PDE-3 inhibitor used in managing heart failure?", "options": [{"label": "A", "text": "Milrinone", "correct": true}, {"label": "B", "text": "Roflumilast", "correct": false}, {"label": "C", "text": "Cilostazol", "correct": false}, {"label": "D", "text": "Theophylline.", "correct": false}], "correct_answer": "A. Milrinone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Milrinone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PDE-3 inhibitor</strong>; increases <strong>cAMP</strong> levels, leading to <strong>increased contractility</strong> and <strong>vasodilation</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used for <strong>acute <span class=\"customMeta\" data-dictid=\"da8747dcd51692777185e1ed0554cc\">decompensated</span> heart failure</strong> and to improve <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output in severe heart failure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Roflumilast</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <strong>PDE-4</strong>, reducing inflammation; used in <strong>chronic obstructive <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> disease (COPD)</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily used for managing <strong>COPD</strong>, not heart failure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cilostazol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PDE-3 inhibitor</strong>, but it is used for <strong>intermittent claudication</strong> (not heart failure).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in <strong>peripheral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> disease</strong> for improving walking distance.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Theophylline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PDE inhibitor</strong> but works more on <strong>PDE-4</strong> and is primarily used for <strong>asthma</strong> and <strong>COPD</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> diseases like <strong>asthma</strong> and <strong>COPD</strong>.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wswhIwMiqQHgSeX7AXLd1747296664.mp3", "video": ""}, {"text": "Which of the following is not a mechanism of action of levosimendan?", "options": [{"label": "A", "text": "It inhibits phosphodiesterase-3", "correct": false}, {"label": "B", "text": "It sensitizes cardiac troponin C to Ca2+ ions", "correct": false}, {"label": "C", "text": "It inhibits vasopressin-2 receptor", "correct": true}, {"label": "D", "text": "It opens ATP-sensitive K+ channels in vessels", "correct": false}], "correct_answer": "C. It inhibits vasopressin-2 receptor", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AmxM8nl4aqPBTx9q8YJT1748083178.mp3", "video": ""}, {"text": "Which of the following is true regarding natriuretic peptides and their recombinant forms?", "options": [{"label": "A", "text": "NT-proBNP remains characteristically normal in atrial fibrillation", "correct": false}, {"label": "B", "text": "Nesiritide acts by decreasing the level of cyclic GMP", "correct": false}, {"label": "C", "text": "There are no recombinant forms for ANP", "correct": false}, {"label": "D", "text": "C-type natriuretic peptide is synthesized by kidneys and endothelium", "correct": true}], "correct_answer": "D. C-type natriuretic peptide is synthesized by kidneys and endothelium", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yvyN8Db8PD9qmCOvqQE61748083034.mp3", "video": ""}, {"text": "A known asthmatic is diagnosed with chronic heart failure. Which of the following drugs provides the most therapeutic benefit to this patient?", "options": [{"label": "A", "text": "Carvedilol", "correct": false}, {"label": "B", "text": "Sotalol", "correct": false}, {"label": "C", "text": "Nebivolol", "correct": true}, {"label": "D", "text": "Bisoprolol", "correct": false}], "correct_answer": "C. Nebivolol", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BETA-BLOCKER</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>BETA-1 SELECTIVE</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>VASODILATION</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nebivolol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bisoprolol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metoprolol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carvedilol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Yes</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ksloy9U5ZMrXY2bWTFWJ1748082213.mp3", "video": ""}, {"text": "All of the following are incorrect about sacubitril except?", "options": [{"label": "A", "text": "It inhibits the enzyme that is involved in the synthesis of natriuretic peptides.", "correct": false}, {"label": "B", "text": "It is contraindicated to combine with ACE inhibitors.", "correct": true}, {"label": "C", "text": "The half-life of its active metabolite is 3 hours.", "correct": false}, {"label": "D", "text": "Nesiritide is generally preferred over ARNIs (sacubitril-valsartan).", "correct": false}], "correct_answer": "B. It is contraindicated to combine with ACE inhibitors.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OVstienatJctHXEZ4jKG1748082114.mp3", "video": ""}, {"text": "A patient who had a history of myocardial infarction was diagnosed with heart failure. She was prescribed a drug “A” after monitoring renal function tests and potassium levels for a trial period of 4 weeks. What is the mechanism of action of the drug “A”?", "options": [{"label": "A", "text": "Inhibition of aldosterone receptors in kidneys.", "correct": false}, {"label": "B", "text": "Inhibits conversion of angiotensin 1 into angiotensin 2.", "correct": true}, {"label": "C", "text": "Inhibiting beta-adrenergic receptors of the heart.", "correct": false}, {"label": "D", "text": "Inhibits sodium glucose cotransporter-2 in kidneys.", "correct": false}], "correct_answer": "B. Inhibits conversion of angiotensin 1 into angiotensin 2.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/9SIEWvdnjJ8PSfVEOdKe1736439625.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Drugs for heart failure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inotropic drugs like digoxin</li>\n<li>Diuretics</li>\n<li>ACE inhibitors</li>\n<li>Angiotensin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers</li>\n<li>Beta-blockers</li>\n<li>Vasodilators like hydralazine, nitroprusside</li>\n<li>Synthetic BNP: nesiritide</li>\n<li>Neprilysin inhibitor: sacubitril</li>\n<li>Aldosterone antagonists</li>\n<li>SGLT-2 inhibitors like dapagliflozin</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ybUKdUqp5W8DSecC6GgF1748081878.mp3", "video": ""}, {"text": "A patient was admitted with chest pain, and the ECG is given in the image below. His blood report shows a troponin level of 210 ng/ml. Which of the following is less likely to be involved in managing this patient?", "options": [{"label": "A", "text": "Ticagrelor", "correct": false}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Tenecteplase", "correct": true}, {"label": "D", "text": "Bivalirudin", "correct": false}], "correct_answer": "C. Tenecteplase", "question_images": ["https://image.prepladder.com/content/w0yrgfgcViKSSXw9P5t71736439069.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oxygen</li>\n<li>Nitrates</li>\n<li>Morphine</li>\n<li>Loading lose (dual antiplatelets + statin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definitive management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulation</strong> - one of the below</p>\n<ul>\n<li>Unfractionated heparin</li>\n<li>Enoxaparin (<strong>low <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparin</strong>)</li>\n<li>Bivalirudin (<strong>direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> inhibitor</strong>)</li>\n<li>Fondaparinux (<strong>factor Xa inhibitor</strong>)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Long-term management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lifestyle modifications</li>\n<li>Dual antiplatelets</li>\n<li>ACE inhibitors</li>\n<li>Beta-blockers</li>\n<li>Statins</li>\n<li>Oral hypoglycemics (if diabetic)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IjeQolrmlF7XsnSiFhV01748081404.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 28 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following thiazide diuretics is appropriate for a 34-year-old man with hypertension and stage 4 chronic kidney disease, characterized by an estimated glomerular filtration rate (eGFR) below 30?", "options": [{"label": "A", "text": "Chlorothiazide", "correct": false}, {"label": "B", "text": "Chlorthalidone", "correct": false}, {"label": "C", "text": "Metolazone", "correct": true}, {"label": "D", "text": "Hydrocholorothiazide", "correct": false}], "correct_answer": "C. Metolazone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a history of hypertension is given the drug ‘X’. Identify ‘X’?", "options": [{"label": "A", "text": "Captopril", "correct": false}, {"label": "B", "text": "Spironolactone", "correct": false}, {"label": "C", "text": "Aliskiren", "correct": true}, {"label": "D", "text": "Losartan", "correct": false}], "correct_answer": "C. Aliskiren", "question_images": ["https://image.prepladder.com/notes/EOE7jsFvXRLFfak8aUDT1747395089.png"], "explanation_images": ["https://image.prepladder.com/content/OmHIjqA0rvyTvdwnYs9g1746171886.png"], "explanation": "<p>Correct Answer C - Alisk\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug elicits the following response on blood pressure and heart rate, as shown in the image?", "options": [{"label": "A", "text": "Norepinephrine", "correct": true}, {"label": "B", "text": "Isoproterenol", "correct": false}, {"label": "C", "text": "Epinephrine", "correct": false}, {"label": "D", "text": "Dopamine", "correct": false}], "correct_answer": "A. Norepinephrine", "question_images": ["https://image.prepladder.com/notes/eNotMVHhFqCwIGkQ0lnI1747395385.png"], "explanation_images": [], "explanation": "<p>Correct Answer A - Norepinephrine</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Norepinephrine, or noradrenaline, is a <span class=\"customMeta\" data-dictid=\"504306528f1692777199a0b2437267\">sympathomimetic</span> drug used primarily as a vasopressor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action (MOA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It acts on α1 and β1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors and has some <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for alpha-2 receptors.</p>\n<ul>\n<li>Activation of α1 receptors causes vasoconstriction, increasing <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> resistance and blood pressure.</li>\n<li>Activation of β1 receptors increases heart rate and myocardial contractility.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> (e.g., <span class=\"customMeta\" data-dictid=\"39f67d7dde16927771985d3952058d\">septic</span> shock, <span class=\"customMeta\" data-dictid=\"25ec593008169277718360336a849a\">cardiogenic</span> shock).</li>\n<li>Cardiac arrest.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cardiovascular: Arrhythmias, bradycardia, hypertension.</li>\n<li>CNS: Anxiety, headache, tremor.</li>\n<li>Gastrointestinal: Nausea, vomiting.</li>\n<li>Respiratory: Respiratory difficulty, dyspnea.</li>\n<li>Metabolic: Hyperglycemia, <span class=\"customMeta\" data-dictid=\"b82539c9ae1692777191a3f7ddd7bb\">lactic</span> acidosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Peripheral <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> (risk of ischemia).</li>\n<li>During <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> with <span class=\"customMeta\" data-dictid=\"d85814684116927771852e645f8a96\">cyclopropane</span> or <span class=\"customMeta\" data-dictid=\"c65071bcf116927771888d40d93bf3\">halothane</span> (due to the risk of arrhythmias).</li>\n<li>Hypotension is due to <span class=\"customMeta\" data-dictid=\"b9b690b70c16927771833aae799b33\">blood volume</span> deficits (hypovolemia) until an adequate fluid replacement.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the false statement regarding statins?", "options": [{"label": "A", "text": "Although HMG-CoA reductase inhibitors substantially reduce the risk of cardiovascular events, there is a mild increase in lipoprotein a (Lpa) levels.", "correct": false}, {"label": "B", "text": "These drugs should not be stopped even in severe conditions like injury, surgery etc.", "correct": false}, {"label": "C", "text": "They can be given with verapamil and other enzyme inhibitors", "correct": true}, {"label": "D", "text": "With long-term use, there is a slight increase in the incidence of type 2 diabetes mellitus.", "correct": false}], "correct_answer": "C. They can be given with verapamil and other enzyme inhibitors", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/B24nlaRuyXwRtzPdvy701745384499.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Statins / <span class=\"customMeta\" data-dictid=\"944fb955251692777189b1e05ebecf\">HMG</span> <span class=\"customMeta\" data-dictid=\"fdf03479ad16927771847526907130\">CoA</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> inhibitors</strong></p>\n<ul>\n<li>Atorvastatin</li>\n<li>Rosuvastatin</li>\n<li>Simvastatin</li>\n<li>Pitavastatin</li>\n<li>Pravastatin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"944fb955251692777189b1e05ebecf\">HMG</span> <span class=\"customMeta\" data-dictid=\"fdf03479ad16927771847526907130\">CoA</span> <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> ➜ <strong>￬</strong>cholesterol production in the liver (<strong>￬</strong>LDL cholesterol)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibrates / Activates PPAR-α</strong></p>\n<ul>\n<li>Gemfibrozil</li>\n<li>Bezafibrate</li>\n<li>Fenofibrate</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activates PPAR-α ➜ <strong>￪</strong>expression of genes involved responsible for triglycerides <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> and <span class=\"customMeta\" data-dictid=\"0f5003332416927772029436c396b6\">VLDL</span> clearance.</p>\n<p>Fibrates can <strong>￬</strong>triglycerides and <strong>￪</strong>HDL cholesterol levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Resins / <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">Bile</span> acid sequestrants </strong></p>\n<ul>\n<li>Cholestyramine</li>\n<li>Colesevelam</li>\n<li>Colestipol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sequestrates <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acids (<strong>￬</strong>recycling of <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acids from the <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> to the liver) ➜ To compensate for this, the liver increases the conversion of cholesterol into <span class=\"customMeta\" data-dictid=\"cf978047b61692777183c0569f21f2\">bile</span> acid ➜ <strong>￬</strong>in <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> cholesterol levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lipolysis inhibitor/Triglyceride <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> inhibitor</strong></p>\n<ul>\n<li>Niacin (Nicotinic acid)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"4a5c848a1e1692777191a2d5d303a0\">lipolysis</span> in <span class=\"customMeta\" data-dictid=\"5c2a4a949d16927771802ba54640cc\">adipose</span> tissue ➜ <strong>￬</strong>hepatic <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of <span class=\"customMeta\" data-dictid=\"0f5003332416927772029436c396b6\">VLDL</span> and <span class=\"customMeta\" data-dictid=\"4e4438ab5c16927771919ca536a59f\">LDL</span> ➜ <strong>￬</strong>LDL cholesterol and triglycerides in blood.</p>\n<p>Niacin also inhibits the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of <span class=\"customMeta\" data-dictid=\"5ceb81d29516927771884c732da32e\">HDL</span> ➜ <strong>￪</strong>HDL levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ezetimibe</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disrupts cholesterol and <span class=\"customMeta\" data-dictid=\"fb2747c18d169277719515aee6cb10\">phytosterol</span> <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> in small intestines via PCIL1 <span class=\"customMeta\" data-dictid=\"850b296dd316927772005b651f6e87\">transporter</span> protein interference.</li>\n<li>Ezetimibe, <strong>with statins, enhances <span class=\"customMeta\" data-dictid=\"fec284b7b316927771911abdb6eb5b\">LDL-C</span> reduction</strong> by inhibiting the rise of statin-induced cholesterol synthesis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the correct match, regarding the drug and its adverse effect.:", "options": [{"label": "A", "text": "Hydralazine - heart failure", "correct": false}, {"label": "B", "text": "Atenolol - hemolytic anemia", "correct": false}, {"label": "C", "text": "Aliskiren - hypokalemia", "correct": false}, {"label": "D", "text": "Verapamil - Constipation", "correct": true}], "correct_answer": "D. Verapamil - Constipation", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Verapamil</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class of Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenylalkylamine class of CCB</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks<strong> </strong>the influx of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> ions into smooth muscle cells, which reduces the force of <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> and dilates the blood vessels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It primarily affects <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> muscle, leading to<strong> </strong><strong>negative <span class=\"customMeta\" data-dictid=\"d44f29df6116927771902150f69464\">inotropic</span> effects</strong> and <strong>slow <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> through the AV node</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rapid from the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> tract; peak <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentrations in 1- 2 hours.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Elimination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extensively metabolized in the liver, excreted in urine.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Constipation, dizziness, headache, hypotension.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An anti–arrhythmic drug is shown to have the following effect. It is effective in both atrial and ventricular arrhythmias. Identify the drug.", "options": [{"label": "A", "text": "Tocainide", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Quinidine", "correct": true}, {"label": "D", "text": "Lignocaine", "correct": false}], "correct_answer": "C. Quinidine", "question_images": ["https://image.prepladder.com/notes/yJ8qryNVuJPpthK2j3Ga1746705601.png"], "explanation_images": ["https://image.prepladder.com/notes/3jC6vzPc673ei9SaHOiI1746706438.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following antiarrhythmic drugs with their mechanism of action: Mechanism of action Drug Na + channel blocker K + channel blocker Na + , K + ATPase inhibitor Beta-blocker Quinidine Digoxin Esmolol Ibutilde", "options": [{"label": "A", "text": "1-d, 2-b, 3-a, 4-c", "correct": false}, {"label": "B", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}, {"label": "C", "text": "1-a, 2-d, 3-b, 4-c", "correct": true}, {"label": "D", "text": "1-d, 2-c, 3-a, 4-b", "correct": false}], "correct_answer": "C. 1-a, 2-d, 3-b, 4-c", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Quinidine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Is a <strong>Na</strong><strong><sup>+</sup></strong><strong> channel blocker, which is a class I </strong>antiarrhythmic drug that acts by <strong>blocking sodium channels</strong> in the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> cells. By <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> these channels, it decreases the influx of sodium ions during the <span class=\"customMeta\" data-dictid=\"dbaf58dd301692777186f2a8d7b3a0\">depolarization</span> phase of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Digoxin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>It is a Na</strong><strong><sup>+</sup></strong><strong> K</strong><strong><sup>+</sup></strong><strong> ATPase inhibitor, </strong>which<strong> </strong>is not primarily considered an <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> drug but rather a<strong> <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> glycoside.</strong> However, it does have some <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> effects. Digoxin <strong>inhibits the activity of the Na</strong><strong><sup>+</sup></strong><strong> K</strong><strong><sup>+</sup></strong><strong> ATPase pump</strong>, and <strong>increases <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels</strong>, leading to increased <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> of the heart. This indirectly helps to control certain arrhythmias, such as atrial fibrillation<strong> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esmolol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It belongs to the class of <strong>beta-blockers</strong>, specifically a short-acting selective beta-1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blocker. It works by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the beta-1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors in the heart, thereby reducing the effects of <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> stimulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ibutilide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is a <strong>potassium channel blocker, which</strong> is a class <strong>III </strong>antiarrhythmic drug that primarily <strong>blocks <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> channels </strong>in the heart. By inhibiting these channels, it <strong>prolongs the <span class=\"customMeta\" data-dictid=\"40451a27bd1692777197d6c276d0bc\">repolarization</span> phase </strong>of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential, resulting in an increase in the <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> duration and effective <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> period.</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:659px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class of Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sodium channel blockers (Class 1) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class 1A </strong></p>\n<ul>\n<li>Quinidine</li>\n<li>Procainamide</li>\n<li>Disopyramide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks sodium channels (Na+) during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential.<br/>\n\t\t\t </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class 1B</strong></p>\n<ul>\n<li>Lidocaine</li>\n<li>Mexiletine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks sodium channels (Na+) during <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential, but with fast dissociation.<br/>\n\t\t\t </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class 1C</strong></p>\n<ul>\n<li>Flecainide</li>\n<li>Propafenone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potent <span class=\"customMeta\" data-dictid=\"276be2047116927771989f7bf5ed02\">sodium channel</span> blockers (Na+) with slow <span class=\"customMeta\" data-dictid=\"18fb34ab321692777186e9bc95a726\">dissociation</span> from the channel.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Beta-blockers (Class 2)</strong></p>\n<ul>\n<li>Propranolol</li>\n<li>Metoprolol</li>\n<li>Esmolol</li>\n<li>Carvedilol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decrease SA and AV nodal activity by ↓ cAMP, thereby ↓ Ca currents.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potassium channel blockers (Class 3)</strong></p>\n<ul>\n<li>Amiodarone</li>\n<li>Ibutilide</li>\n<li>Dofetilide</li>\n<li>Sotalol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Delays repolarization, lengthens the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> action potential, and increases the <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> period.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcium channel blockers (Class 4)</strong></p>\n<ul>\n<li>Diltiazem</li>\n<li>Verapamil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reducing <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> influx during <span class=\"customMeta\" data-dictid=\"b0fcf93d611692777195e97ec23460\">phase 2</span> of the <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> and decreases myocardial contractility, heart rate, and AV nodal <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> velocity.</p>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Miscellaneous drugs (Class 5)</strong></p>\n<ul>\n<li>Atropine</li>\n<li>Adenosine</li>\n<li>Digoxin</li>\n<li> </li>\n<li>Magnesium sulfate</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Atropine: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> in bradyarrhythmias</li>\n<li>Adenosine: used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attacks of <span class=\"customMeta\" data-dictid=\"cd15fe58221692777194fbb9eec8d1\">paroxysmal</span> <span class=\"customMeta\" data-dictid=\"619efd9f7b169277719928c9441919\">supraventricular</span> <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> and to treat supra-ventricular <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> in <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> patients</li>\n<li>Digoxin: Treat atrial flutter/fibrillation</li>\n<li>Magnesium sulfate: <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> in Torsades <span class=\"customMeta\" data-dictid=\"233d458dd316927771854358419c86\">de</span> pointes</li>\n</ol>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the medications listed below is considered safe for the treatment of pregnancy-induced hypertension?", "options": [{"label": "A", "text": "Lisinopril", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Alpha methyldopa", "correct": true}, {"label": "D", "text": "Losartan", "correct": false}], "correct_answer": "C. Alpha methyldopa", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\"&gt;Alpha&lt;/span&gt; methyldopa</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Antihypertensives in Pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>DOC: Labetaolol</strong> (Beta-blocker)</li>\n<li>If chronic <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> develops, <strong>Alpha methyldopa</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Safe antihypertensives during pregnancy</strong></li>\n<li>Labetalol, Hydralazine, Methyldopa, and <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> channel blockers like Nifedipine. (LHMC- Lady Hardinge Medical College)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Unsafe <span class=\"customMeta\" data-dictid=\"a9952795951692777181001d03753a\">antihypertensive</span> drugs during pregnancy:</strong></p>\n<ul>\n<li><strong>ACE inhibitors (Option A) &amp; ARBs (Option D):</strong> Can lead to <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"133b86a0a516927771809ea08682e8\">agenesis</span> in the fetus, causing <span class=\"customMeta\" data-dictid=\"41fc142ae61692777194c3f69d3d74\">oligohydramnios</span> and leading to POTTER sequence (Pulmonary hypoplasia, Oligohydramnios, Twisted/wrinkled skin, Twisted Potter faces, <span class=\"customMeta\" data-dictid=\"c8ed8e0fb61692777187c860f7056f\">Extremity</span> defects, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> agenesis).</li>\n<li><strong>Thiazides/Loop diuretics/Beta-blockers (Option B):</strong> Bear the risk of <strong>placental ischemia</strong>, which can be fatal to the fetus.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to the OPD with a chronic dry cough with no fever or other associated symptoms. He had recently been started on an antihypertensive for hypertension. Which among the following is most likely responsible for causing these symptoms?", "options": [{"label": "A", "text": "Bradykinin and renin", "correct": false}, {"label": "B", "text": "Angiotensin II and bradykinin", "correct": false}, {"label": "C", "text": "Only bradykinin", "correct": true}, {"label": "D", "text": "Histamine", "correct": false}], "correct_answer": "C. Only bradykinin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Only bradykinin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decrease in blood pressure, especially upon <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of therapy or with <strong>dosage increases.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hyperkalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels due to <strong>reduced <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> secretion.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cough</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Persistent dry cough, possibly due to <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> buildup in the lungs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Angioedema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Due to <strong>increased <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> levels,</strong> <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of deeper layers of skin, particularly around the eyes and lips, can be life-threatening.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rashes/Urticaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Skin reactions like rashes or <span class=\"customMeta\" data-dictid=\"14ccc7cf1c1692777189d4fb9d1fb5\">hives</span> occur in a small percentage of users.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dysgeusia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Reversible</strong> taste changes are <strong>more common with captopril</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rare Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Granulocytopenia</strong> (low white blood cells) and <span class=\"customMeta\" data-dictid=\"1f58deccf71692777196e64781a01a\">proteinuria</span> (excess protein in urine) are more concerning in patients with <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Failure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Possible in patients with <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> due to decreased <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> filtration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fetal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>ACE inhibitors are <strong>contraindicated during pregnancy </strong>due to potential harm to the fetus, including <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> damage due to <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of the <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> renin-angiotensin system.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In patients with indications for warfarin usage, what is the recommended range of INR in a patient with mechanical heart valves?", "options": [{"label": "A", "text": "1.0-1.5", "correct": false}, {"label": "B", "text": "2.0-3.0", "correct": false}, {"label": "C", "text": "2.5-3.5", "correct": true}, {"label": "D", "text": "3.5-4.5", "correct": false}], "correct_answer": "C. 2.5-3.5", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - 2.5-3.5\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred medication for managing ventricular arrhythmia caused by digoxin?", "options": [{"label": "A", "text": "Procainamide", "correct": false}, {"label": "B", "text": "Lignocaine", "correct": true}, {"label": "C", "text": "Atropine", "correct": false}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "B. Lignocaine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Lig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 57-year-old man was brought to the hospital with complaints of dizziness and breathlessness. During the physical examination, his face appears to be discoloured. His current medication includes Amiodarone, Metoprolol, Verapamil, Lisinopril and Amlodipine. Which of the following drugs is responsible for these skin changes?", "options": [{"label": "A", "text": "Amiodarone", "correct": true}, {"label": "B", "text": "Amlodipine", "correct": false}, {"label": "C", "text": "Metoprolol", "correct": false}, {"label": "D", "text": "Verapamil", "correct": false}], "correct_answer": "A. Amiodarone", "question_images": ["https://image.prepladder.com/notes/veS66e8ib9jgVzycnxp91747048052.png"], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Amiodarone</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>MOA </p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Prolonged <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> duration and QT interval by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> delayed <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels.</li>\n<li>Blocks inactivated Na+ channels, with rapid channel recovery (Decrease <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> slope).</li>\n<li>Partially inhibits myocardial Ca2+ channels, adding to its <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> effects.</li>\n<li>Used to treat both atrial and <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> fibrillation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>To maintain normal <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> rhythm during <span class=\"customMeta\" data-dictid=\"e6a04221a41692777182825f0f08da\">atrial fibrillation</span> and prevent <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> tachycardia.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Adverse effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Hypotension and Bradycardia (with i.v administration or after drug accumulation)</li>\n<li>Photosensitivity: Skin <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> - Purple colour (purple man syndrome, smurf syndrome)</li>\n<li>Corneal microdeposits: Reversible upon drug discontinuation.</li>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"6e483e166a169277718133d060d311\">alveolitis</span> and <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> (On long-term use)</li>\n<li>Peripheral neuropathy</li>\n<li>Thyroid Dysfunction: Interfere with <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> function as it acts as a source of <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> and can potentially lead to goitre, <span class=\"customMeta\" data-dictid=\"8d4d1904791692777189941782330d\">hypothyroidism</span> (Wolf Chaikoff effect), or, in rare cases, <span class=\"customMeta\" data-dictid=\"df46bcd43116927771892090901263\">hyperthyroidism</span> (Jos-Basedow effect).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Interactions</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Inhibits CYP3A4, CYP2C9, and P-glycoprotein, leading to potential interactions with drugs metabolized by this system.</li>\n<li>Increases <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> levels of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> and warfarin.</li>\n<li>Additive AV block with beta-blockers or <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockers.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the half-life of digoxin?", "options": [{"label": "A", "text": "12 hours", "correct": false}, {"label": "B", "text": "24 hours", "correct": false}, {"label": "C", "text": "36 hours", "correct": true}, {"label": "D", "text": "48 hours", "correct": false}], "correct_answer": "C. 36 hours", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Inhaled Nitric oxide is approved for the treatment of?", "options": [{"label": "A", "text": "Labile hypertension", "correct": false}, {"label": "B", "text": "Pulmonary hypertension", "correct": true}, {"label": "C", "text": "Treatment of resistant migraine", "correct": false}, {"label": "D", "text": "Resistant Parkinson’s disease", "correct": false}], "correct_answer": "B. Pulmonary hypertension", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/sEIVuTVZ2mv57FcmInRM1745571143.png"], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\"&gt;Pulmonary&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\"&gt;hypertension&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Nitric Oxide</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Inhaled <span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\">nitric</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> </strong>is a gas that is used to treat <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> because it acts as a potent vasodilator, meaning it relaxes the smooth muscle in the walls of the <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> arteries and improves blood flow.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Activation of <span class=\"customMeta\" data-dictid=\"deb73df780169277718873138a593e\">guanylate</span> cyclase, which converts <span class=\"customMeta\" data-dictid=\"1231a711af1692777188843b09b991\">guanosine</span> <span class=\"customMeta\" data-dictid=\"7fa0befcdb16927772002b0b0b23d1\">triphosphate</span> (GTP) to <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> <span class=\"customMeta\" data-dictid=\"1231a711af1692777188843b09b991\">guanosine</span> <span class=\"customMeta\" data-dictid=\"8dcffccac016927771927605248b59\">monophosphate</span> (cGMP)</p>\n<p>cGMP causes <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> of the smooth muscle cells in the <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> arteries, leading to <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> of the vessels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Therapeutic indication</strong></p>\n<ul>\n<li>Pulmonary arterial hypertension</li>\n<li>Rescue therapy for severely hypoxemic patients</li>\n</ul>\n<p> </p>\n<p><strong>Diagnostic indication </strong></p>\n<ul>\n<li>To evaluate <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"d4b70f945316927771972d75389cf0\">reactivity</span> during <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> catheterisation.</li>\n<li>To determine <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> capacity across the alveolar-capillary unit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Headache, <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting</li>\n<li>Methemoglobinemia</li>\n<li>It may worsen left <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> performance in those with impaired <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> function.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Drugs for Pulmonary <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> hypertension</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">PDE 5 Inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Sildenafil (Viagra), Tadalafil</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Endothelin Receptor Antagonists</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Bosentan, Sitaxsentan, Ambrisentan</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">PG-I2 Analogs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Treprostinil, Iloprost, Epoprostenol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Soluble Guanylyl Cyclase Activators</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Riociguat</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">I-2 <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> agonist</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Selexipag</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Continuous NO Inhalation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Nitric oxide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Calcium Channel Blockers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom\">\n<p style=\"text-align: center;\">Amlodipine, Nifedipine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old chronic hypertensive woman comes to the OPD for preconception counselling. Which of the following antihypertensives should be discontinued in this patient?", "options": [{"label": "A", "text": "Labetalol", "correct": false}, {"label": "B", "text": "Calcium channel blocker", "correct": false}, {"label": "C", "text": "Angiotensin-converting enzyme inhibitor", "correct": true}, {"label": "D", "text": "Alpha - methyldopa", "correct": false}], "correct_answer": "C. Angiotensin-converting enzyme inhibitor", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Antihypertensives in pregnancy </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>To be used </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>To be avoided </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Labetalol (α + β <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist)</li>\n<li>Nifedipine (Calcium channel <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> *)</li>\n<li>α - Methyldopa</li>\n<li>Hydralazine</li>\n<li>Thiazides can be used in chronic <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> in pregnant women</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>ACEi and ARB - teratogenic</li>\n<li>Diuretic - reduces <span class=\"customMeta\" data-dictid=\"091c4fd1e61692777201ec50806bc4\">uteroplacental</span> perfusion</li>\n<li>Non-selective beta-blocker</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>* CCB can be useful in preeclampsia, but they must be stopped before labour as they can weaken <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> contractions</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who was recently started on an antihypertensive presented with the following presentation, as shown in the image below. Which of the following antihypertensive medications was most likely prescribed to him?", "options": [{"label": "A", "text": "Lisinopril", "correct": true}, {"label": "B", "text": "Nifedipine", "correct": false}, {"label": "C", "text": "Atenolol", "correct": false}, {"label": "D", "text": "Clonidine", "correct": false}], "correct_answer": "A. Lisinopril", "question_images": ["https://image.prepladder.com/notes/MTwUFZagFZb8Qld71PTP1746442804.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:659px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects of <span class=\"customMeta\" data-dictid=\"881411ec321692777181ca707f2515\">angiotensin-converting enzyme</span> inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decrease in blood pressure, especially upon <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of therapy or with <strong>dosage increases.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hyperkalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels due to<strong> <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> secretion.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cough</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Persistent dry cough, possibly due to <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> buildup in the lungs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Angioedema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Due to<strong> increased <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> levels,</strong> <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of deeper layers of skin, particularly around the eyes and lips, can be life-threatening.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Rashes/Urticaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Skin reactions like rashes or <span class=\"customMeta\" data-dictid=\"14ccc7cf1c1692777189d4fb9d1fb5\">hives</span> occur in a small percentage of users.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dysgeusia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Reversible</strong> taste changes are <strong>more common with captopril.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Rare Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Granulocytopenia</strong> (low white blood cells) and <span class=\"customMeta\" data-dictid=\"1f58deccf71692777196e64781a01a\">proteinuria</span> (excess protein in urine) are more concerning in patients with <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Failure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Possible in patients with <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> due to decreased <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> filtration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fetal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>ACE inhibitors are <strong>contraindicated during pregnancy</strong> due to potential harm to the fetus, including <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> damage due to <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of the <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> renin-angiotensin system.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-hypertensive medication is suitable for administration to a patient suffering from renal insufficiency, exhibiting symptoms of significantly reduced urine output, pedal edema, headache, and a blood pressure reading of 160/90?", "options": [{"label": "A", "text": "Aliskiren", "correct": false}, {"label": "B", "text": "Chlorthalidone", "correct": false}, {"label": "C", "text": "Amlodipine", "correct": true}, {"label": "D", "text": "Prazosin", "correct": false}], "correct_answer": "C. Amlodipine", "question_images": [], "explanation_images": [], "explanation": "<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Rationale for Choice</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Nifedipine </strong></p>\n<p>(Short-acting)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Primarily used for<strong> <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> pectoris.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is not recommended for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management due to its <strong>short duration of action</strong> and potential for <strong>reflex tachycardia</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Nicardipine</strong></p>\n<p>(Short-acting)</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is commonly used in the management of <strong>hypertensive emergencies </strong>and <strong>perioperative hypertension</strong> or severe <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> in the <span class=\"customMeta\" data-dictid=\"901bf573f216927771905f0abedca2\">intensive</span> care unit.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The short duration of action makes it less suitable for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clevidipine</strong></p>\n<p>(Ultra-short-acting)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very short half-life</strong> makes it unsuitable for long-term <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Amlodipine</strong></p>\n<p>(Long-acting)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Recommended as a first-line or add-on therapy for the<strong> long-term management of hypertension.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Preferred choice due to its long duration of action (up to 24 hours), once-daily dosing, and effectiveness in <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> with good tolerability.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following side effects are likely to be observed when a patient already taking metoprolol is prescribed verapamil? a) Bradycardia with Av Block b) Torsades De Pointes c) Tachycardia d) Ventricular Fibrillation", "options": [{"label": "A", "text": "a only", "correct": true}, {"label": "B", "text": "a &amp;amp; b", "correct": false}, {"label": "C", "text": "a &amp;amp; c", "correct": false}, {"label": "D", "text": "b &amp;amp; d", "correct": false}], "correct_answer": "A. a only", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs acts by inhibiting the late sodium current in the heart?", "options": [{"label": "A", "text": "Ivabradine", "correct": false}, {"label": "B", "text": "Ranolazine", "correct": true}, {"label": "C", "text": "Trimetazidine", "correct": false}, {"label": "D", "text": "Fasudil", "correct": false}], "correct_answer": "B. Ranolazine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Ranolazine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Inhibits the late sodium current in cardiomyocytes, which helps to reduce <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> sodium accumulation during ischemic conditions</li>\n<li>Indirectly reduces <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> <span class=\"customMeta\" data-dictid=\"9d02a99d051692777194aa3375023b\">overload</span> in <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> cells and improves myocardial relaxation, leading to an <span class=\"customMeta\" data-dictid=\"79b064c9dd1692777181324cc128fe\">anti-ischemic</span> effect.</li>\n<li>It decreases <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> diastolic tension, reduces myocardial oxygen consumption, and improves myocardial perfusion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Used as add-on therapy as an <span class=\"customMeta\" data-dictid=\"27f1650ee916927771810ee0b435a7\">Antianginal</span> agent for <strong>Chronic stable angina.</strong></li>\n<li>Reduces the frequency of <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> pectoris and improves exercise tolerance.</li>\n<li>Ventricular tachycardia.</li>\n<li>Improves <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> control (lower HbA1c and increase insulin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effect </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Dizziness, headache, <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and asthenia</li>\n<li>Constipation and Liver failure</li>\n<li>QT-prolongation and rarely <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">Ventricular</span> <span class=\"customMeta\" data-dictid=\"5280ec6ae91692777182aa6322ae68\">arrhythmia</span> such as Torsades <span class=\"customMeta\" data-dictid=\"233d458dd316927771854358419c86\">de</span> pointes.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antiarrhythmic drugs is contraindicated in a patient with interstitial lung disease?", "options": [{"label": "A", "text": "Amiodarone", "correct": true}, {"label": "B", "text": "Sotalol", "correct": false}, {"label": "C", "text": "Quinidine", "correct": false}, {"label": "D", "text": "Lignocaine", "correct": false}], "correct_answer": "A. Amiodarone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Amiodarone</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Lung disorders </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Amniodarone </strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p>Pulmonary fibrosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bleomycin </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Busulfan</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nitrofurantoin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rarely associated with chronic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> fibrosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cyclophosphamide </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p>Interstitial pneumonitis, which can lead to <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> fibrosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Methotrexate </strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A person presents with acute chest pain. Nitro-glycerine was given sublingually, and pain relief occurred within a minute. What is the mechanism of this drug?", "options": [{"label": "A", "text": "Release of endothelin", "correct": false}, {"label": "B", "text": "Release of nitric oxide", "correct": true}, {"label": "C", "text": "Calcium channel blockade", "correct": false}, {"label": "D", "text": "Beta blockade", "correct": false}], "correct_answer": "B. Release of nitric oxide", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lNxYLcNSI4nBzv8tTlXc1747987556.png"], "explanation": "<p>Correct Answer B - Release of &lt;span class=\"customMeta\" data-dictid=\"5536b77611169277719356d32e638a\"&gt;nitric&lt;/span&gt; oxide</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nitrates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Glyceryl trinitrate</li>\n<li>Isosorbide dinitrate</li>\n<li>Isosorbide mononitrate</li>\n<li>Pentaerythritol tetranitrate</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"PPH050 Nitrates MOA\" data-author=\"NA\" data-hash=\"13248\" data-license=\"NA\" data-source=\"NA\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/lNxYLcNSI4nBzv8tTlXc1747987556.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Venodilation → Reduce <span class=\"customMeta\" data-dictid=\"628ed9c26316927771964889249b3b\">preload</span> → Reduce myocardial <span class=\"customMeta\" data-dictid=\"3d46029a83169277718580263882c3\">contractility</span> → Decreased O<sub>2</sub> demand.</li>\n<li>Dilates <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (increase cGMP): effective in <span class=\"customMeta\" data-dictid=\"1af6c1e77d169277720168838edbbe\">vasospastic</span> angina.</li>\n<li>Redistribution of <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> to the ischemic area (<strong>Robinhood phenomenon</strong>).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Angina (stable, <span class=\"customMeta\" data-dictid=\"1af6c1e77d169277720168838edbbe\">vasospastic</span> and chronic)</li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> syndrome or myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> (STEMI/NSTEMI)</li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema</li>\n<li>Abdominal colicky pain</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient has pain in the facial nerve distribution while chewing and speaking. Which of the following drugs should be given for the treatment?", "options": [{"label": "A", "text": "Lamotrigine", "correct": false}, {"label": "B", "text": "Carbamazepine", "correct": true}, {"label": "C", "text": "Phenobarbitone", "correct": false}, {"label": "D", "text": "Haloperidol", "correct": false}], "correct_answer": "B. Carbamazepine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Carbamazepine</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> <span class=\"customMeta\" data-dictid=\"c4cb87045a169277719307432604a6\">neuralgia</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Carbamazepine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits high-frequency neuronal discharges and modulates voltage-gated sodium channels.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Trigeminal neuralgia</p>\n<p>GTCS, partial seizures, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sedation, dizziness, ataxia, GI disturbances, <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> suppression, <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reactions, water retention.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Gabapentin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enhances GABA release modulates voltage-sensitive Ca2+ channels.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Partial seizures, post-herpetic neuralgia, <span class=\"customMeta\" data-dictid=\"294b46d9061692777192d5d9fe869a\">migraine</span> prophylaxis.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sedation, tiredness, dizziness, tremor, unsteadiness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diazepam</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enhances GABAergic neurotransmission.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Status epilepticus,</p>\n<p>Febrile seizure.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thrombophlebitis, hypotension, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Topiramate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Multiple mechanisms, including <span class=\"customMeta\" data-dictid=\"276be2047116927771989f7bf5ed02\">sodium channel</span> inactivation, GABA potentiation, <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonism, and <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> channel modulation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>GTCS, myoclonic epilepsy, and absence of seizures.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Impairment of attention, sedation, ataxia, word-finding difficulties, poor memory, weight loss, paresthesias, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> stones.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the subsequent antihypertensive medications are contraindicated during pregnancy?", "options": [{"label": "A", "text": "Alpha methyldopa", "correct": false}, {"label": "B", "text": "Hydralazine", "correct": false}, {"label": "C", "text": "Propranolol", "correct": true}, {"label": "D", "text": "Labetalol", "correct": false}], "correct_answer": "C. Propranolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C: P\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of these drugs stimulates PPAR-alpha?", "options": [{"label": "A", "text": "Gemfibrozil", "correct": true}, {"label": "B", "text": "Ezetimibe", "correct": false}, {"label": "C", "text": "Colestipol", "correct": false}, {"label": "D", "text": "Simvastatin", "correct": false}], "correct_answer": "A. Gemfibrozil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"c328d6e14f1692777188f13145f8da\"&gt;Gemfibrozil&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Class </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Fibrate or PPAR-α agonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Activate <span class=\"customMeta\" data-dictid=\"c0d194cb5b16927771957905b7aad6\">peroxisome</span> proliferator-activated <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> (PPAR-α), leading to the following effects:</p>\n<ul>\n<li>Reduce <span class=\"customMeta\" data-dictid=\"482f0bd5841692777200af07c2766c\">triglyceride</span> production</li>\n<li>Elevate <span class=\"customMeta\" data-dictid=\"9b15516f9716927771891e052899de\">high-density lipoprotein</span> (HDL) cholesterol levels</li>\n<li>Decrease <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> <span class=\"customMeta\" data-dictid=\"482f0bd5841692777200af07c2766c\">triglyceride</span> synthesis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hyperlipidemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>GI side effects (nausea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, diarrhea)</li>\n<li>Myopathy, especially when used with statins</li>\n<li>Hepatotoxicity (elevated liver enzymes)</li>\n<li>Renal dysfunction</li>\n<li>Gallbladder disease</li>\n<li>Contraindicated in children and pregnancy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who has recently had a myocardial infarction (MI) presents for a follow-up. His cholesterol levels are as follows: total cholesterol 238 mg/dL, triglycerides 125 mg/dL, and HDL 50 mg/dL. He is currently taking atorvastatin, metoprolol, and aspirin. Which of the following medications should be added to his regimen? Ezetimibe Bempedoic acid Evolocumab Gemfibrozil", "options": [{"label": "A", "text": "1,2", "correct": false}, {"label": "B", "text": "2,3", "correct": false}, {"label": "C", "text": "1,2,3", "correct": true}, {"label": "D", "text": "1,2,4", "correct": false}], "correct_answer": "C. 1,2,3", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Scientists administered norepinephrine to guinea pigs, resulting in an increase in systolic and diastolic blood pressure and a decrease in heart rate. What mechanism explains this response?", "options": [{"label": "A", "text": "Beta-1 receptor blockade", "correct": false}, {"label": "B", "text": "Alpha-1 receptor blockade", "correct": false}, {"label": "C", "text": "Baroreceptor stimulation", "correct": true}, {"label": "D", "text": "Baroreceptor inhibition", "correct": false}], "correct_answer": "C. Baroreceptor stimulation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Baroreceptors in <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> and aortic <span class=\"customMeta\" data-dictid=\"9a89dd67841692777182ee412af263\">arch</span> detect BP changes</li>\n<li>Increased BP <span class=\"customMeta\" data-dictid=\"ad337177ee1692777199de941a0cda\">stretches</span> receptors, sending signals to <span class=\"customMeta\" data-dictid=\"53abb386551692777192c4d1f1f5ed\">medulla</span> via <span class=\"customMeta\" data-dictid=\"13b0890d441692777188afdcb41e75\">glossopharyngeal</span> and <span class=\"customMeta\" data-dictid=\"c8da04ed171692777201da65246acd\">vagus</span> nerves</li>\n<li>Medulla inhibits <span class=\"customMeta\" data-dictid=\"52abfe100916927772011ad20f3fda\">vasoconstrictor</span> center and stimulates <span class=\"customMeta\" data-dictid=\"5fb29f3cd516927772017bd29c2581\">vagal</span> <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">parasympathetic</span> center</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Actions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Vasodilation of blood vessels</li>\n<li>Decreased heart rate and <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> strength</li>\n<li>Reduced BP due to lower <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> resistance and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> output</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Importance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Maintains BP stability during activities like standing</li>\n<li>Fastest acting</li>\n<li>Tends to reset within 1-2 days for long-term regulation</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with rheumatoid arthritis is taking indomethacin and an ACE inhibitor for hypertension. What potential side effect is likely to be seen?", "options": [{"label": "A", "text": "Hyperkalemia", "correct": true}, {"label": "B", "text": "Hypercalcemia", "correct": false}, {"label": "C", "text": "Hypernatremia", "correct": false}, {"label": "D", "text": "Hyperphosphatemia", "correct": false}], "correct_answer": "A. Hyperkalemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug Interaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Implication</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">Potassium</span> Supplements/K-sparing diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of <span class=\"customMeta\" data-dictid=\"8bf09336411692777189d1a79bf6a5\">hyperkalemia</span> due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> by <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors combined with potassium-retaining agents.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monitoring <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels is crucial to avoid hyperkalemia, which can cause serious <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> issues such as arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + NSAIDs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NSAIDs can reduce the anti-hypertensive effects of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors and decrease <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> blood flow, increasing the risk of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure (ARF) or oliguria.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use caution when combining NSAIDs with <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors, and closely monitor <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> function, particularly in high-risk patients.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Lithium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACE inhibitors can increase the <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of lithium, potentially leading to <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> toxicity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monitor <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> levels carefully when starting or adjusting <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors in patients taking lithium, and adjust the <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> <span class=\"customMeta\" data-dictid=\"b5bd69c9791692777186a40f45ffb6\">dosage</span> as needed.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Antacids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced <span class=\"customMeta\" data-dictid=\"cf91922bb816927771839a51f2d1e6\">bioavailability</span> of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors due to binding with antacids.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Administer <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors at least two hours before or after antacids to maintain their efficacy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ACE Inhibitors + Diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diuretics enhance the <span class=\"customMeta\" data-dictid=\"bf6247405e16927771891b6a068d36\">hypotensive</span> effects of <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors by depleting sodium and raising <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> levels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In patients already on diuretics, start <span class=\"customMeta\" data-dictid=\"677d11eaae169277718087b28f2992\">ACE</span> inhibitors at a low dose to minimise the risk of excessive <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> reduction initially.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which antihypertensive drug is contraindicated in pregnancy?", "options": [{"label": "A", "text": "Methyldopa", "correct": false}, {"label": "B", "text": "Enalapril", "correct": true}, {"label": "C", "text": "Labetalol", "correct": false}, {"label": "D", "text": "Nifedipine", "correct": false}], "correct_answer": "B. Enalapril", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:659px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypotension</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decrease in blood pressure, especially upon <span class=\"customMeta\" data-dictid=\"a4f93a26c11692777190f1659fa7c9\">initiation</span> of therapy or with <span class=\"customMeta\" data-dictid=\"b5bd69c9791692777186a40f45ffb6\">dosage</span> increases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperkalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cough</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Persistent dry cough, possibly due to <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> buildup in the lungs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Angioedema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Due to increased <span class=\"customMeta\" data-dictid=\"3c5739595d16927771839e61a5855c\">bradykinin</span> levels, <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of deeper layers of skin, particularly around the eyes and lips, can be life-threatening.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rashes/Urticaria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Skin reactions like rashes or <span class=\"customMeta\" data-dictid=\"14ccc7cf1c1692777189d4fb9d1fb5\">hives</span> occur in a small percentage of users.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dysgeusia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reversible taste changes are more common with captopril.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rare Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Granulocytopenia (low white blood cells) and <span class=\"customMeta\" data-dictid=\"1f58deccf71692777196e64781a01a\">proteinuria</span> (excess protein in urine) are more concerning in patients with <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">Renal</span> Failure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Possible in patients with <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"0c9567c6cb16927771996c6bc2b21e\">stenosis</span> due to decreased <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> filtration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fetal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ACE inhibitors are contraindicated during pregnancy due to potential harm to the fetus, including <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> damage due to <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of the <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> renin-angiotensin system.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following beta-adrenergic blockers used in the treatment of chronic heart failure (CHF) is known to prolong survival?", "options": [{"label": "A", "text": "Bisoprolol", "correct": true}, {"label": "B", "text": "Labetalol", "correct": false}, {"label": "C", "text": "Propranolol", "correct": false}, {"label": "D", "text": "Atenolol", "correct": false}], "correct_answer": "A. Bisoprolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - B\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anticoagulant is recommended for a pregnant female at 29 weeks of gestation who develops deep vein thrombosis (DVT) with calf tenderness and is diagnosed via Doppler ultrasound?", "options": [{"label": "A", "text": "Warfarin", "correct": false}, {"label": "B", "text": "Low molecular weight heparin (LMWH)", "correct": true}, {"label": "C", "text": "Apixaban", "correct": false}, {"label": "D", "text": "Rivaroxaban", "correct": false}], "correct_answer": "B. Low molecular weight heparin (LMWH)", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Low &lt;span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\"&gt;Molecular Weight&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"050e27829716927771885eddb2620c\"&gt;Heparin&lt;/span&gt; (LMWH)\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A hypertensive patient is suffering from frequent attacks of renal colic. Preferred anti hypertensive drug is:", "options": [{"label": "A", "text": "Ethacrynic acid", "correct": false}, {"label": "B", "text": "Acetazolamide", "correct": false}, {"label": "C", "text": "Hydrochlorothiazide", "correct": true}, {"label": "D", "text": "Spironolactone", "correct": false}], "correct_answer": "C. Hydrochlorothiazide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Hydrochloroth\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A hypertensive patient stopped antihypertensive medication due to dry eyes, dry mouth and constipation. After stopping the drug, he developed hypertensive emergency (BP &amp;gt; 180/120). Most likely drug is:", "options": [{"label": "A", "text": "Clonidine", "correct": true}, {"label": "B", "text": "Lisinopril", "correct": false}, {"label": "C", "text": "Amlodipine", "correct": false}, {"label": "D", "text": "Telmisartan", "correct": false}], "correct_answer": "A. Clonidine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with raised triglyceride started on medication. He soon developed flushing, gout and raised liver enzymes. Likely cause is:", "options": [{"label": "A", "text": "Nicotinamide", "correct": true}, {"label": "B", "text": "Atorvastatin", "correct": false}, {"label": "C", "text": "Fenofibrate", "correct": false}, {"label": "D", "text": "Cholestyramine", "correct": false}], "correct_answer": "A. Nicotinamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"5eb9769383169277719347453a36cc\"&gt;Nicotinamide&lt;/span&gt; (Niacin)\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An unconscious patient found to have hot dry skin, dilated pupils, abnormal slurred speech. Most likely overdose is?", "options": [{"label": "A", "text": "Dhatura", "correct": true}, {"label": "B", "text": "Cannabis", "correct": false}, {"label": "C", "text": "Alcohol", "correct": false}, {"label": "D", "text": "Cocaine", "correct": false}], "correct_answer": "A. Dhatura", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Dhatu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following adverse effects is least likely to be associated with the use of amiodarone?", "options": [{"label": "A", "text": "Hypothyroidism", "correct": false}, {"label": "B", "text": "Hyperthyroidism", "correct": false}, {"label": "C", "text": "Gynecomastia", "correct": true}, {"label": "D", "text": "Pulmonary fibrosis", "correct": false}], "correct_answer": "C. Gynecomastia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amiodarone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It prolongs <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> duration and QT interval by <strong>blocking delayed <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels.</strong></li>\n<li>Blocks inactivated Na+ channels, with rapid channel recovery (Decrease <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> slope).</li>\n<li>It partially inhibits myocardial Ca2+ channels, adding to its <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> effects.</li>\n<li>It is used to treat <strong>both atrial and <span class=\"customMeta\" data-dictid=\"fc8cac43cc16927772015049bb5ab8\">ventricular</span> fibrillation.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Inhibits CYP3A4, CYP2C9, and P-glycoprotein,</strong> leading to potential interactions with drugs metabolized by this system.</li>\n<li>Increases <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> levels of <strong>digoxin and warfarin.</strong></li>\n<li>Additive AV block with <strong>beta-blockers or <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockers.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypotension and Bradycardia (with i.v administration or after drug accumulation)</li>\n<li><strong>Photosensitivity</strong><strong>: </strong>Skin <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> - Purple colour<strong> </strong><strong>(purple man syndrome, smurf syndrome)</strong></li>\n<li><strong>Corneal microdeposits: </strong>Reversible upon drug discontinuation.</li>\n<li><strong>Pulmonary <span class=\"customMeta\" data-dictid=\"6e483e166a169277718133d060d311\">alveolitis</span> and fibrosis, </strong>on long-term use <strong>(Option D ruled out)</strong></li>\n<li>Peripheral neuropathy</li>\n<li><strong>Thyroid Dysfunction</strong>: Interfere with <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> function as it acts as a source of <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> and can potentially lead to goitre, <span class=\"customMeta\" data-dictid=\"8d4d1904791692777189941782330d\">hypothyroidism</span> <strong>(Wolf Chaikoff effect)</strong>, or, in rare cases, <span class=\"customMeta\" data-dictid=\"df46bcd43116927771892090901263\">hyperthyroidism</span> <strong>(Jos-Basedow effect). </strong><strong>(Option A and B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the Pcsk9 inhibitor.", "options": [{"label": "A", "text": "Evolocumab", "correct": true}, {"label": "B", "text": "Lomitapide", "correct": false}, {"label": "C", "text": "Mipomersen", "correct": false}, {"label": "D", "text": "Torcetrapib", "correct": false}], "correct_answer": "A. Evolocumab", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Evolocu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs reduces mortality in patients with heart failure with reduced ejection fraction (HFREF)?", "options": [{"label": "A", "text": "Metoprolol", "correct": true}, {"label": "B", "text": "Furosemide", "correct": false}, {"label": "C", "text": "Torsemide", "correct": false}, {"label": "D", "text": "Prazosin", "correct": false}], "correct_answer": "A. Metoprolol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Metoprolol</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cardiac side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Extracardiac side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Withdrawal can lead to the <span class=\"customMeta\" data-dictid=\"cc7b2f64b11692777196c8e39b7611\">precipitation</span> of an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> MI.</li>\n<li>Negative <span class=\"customMeta\" data-dictid=\"59e3d661b51692777184a2d67aec94\">chronotropic</span> effects include the development of <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">bradycardia</span> and heart block.</li>\n<li>Heart failure may exacerbate symptoms in patients with <span class=\"customMeta\" data-dictid=\"da8747dcd51692777185e1ed0554cc\">decompensated</span> <span class=\"customMeta\" data-dictid=\"1a5e87d16716927771888f364bce89\">heart failure</span> or preexisting myocardial dysfunction.</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> resistance (contraindicated in patients with <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> due to bronchospasm).</li>\n<li>Exacerbation of <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> disease and worsen <span class=\"customMeta\" data-dictid=\"f01241cd50169277718482b7ac00eb\">claudication</span> and <span class=\"customMeta\" data-dictid=\"eba5ba77ec169277719688fab52fb0\">precipitate</span> Raynaud's disease.</li>\n<li>Masking of the <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> signs (tachycardia).</li>\n<li>Hyperkalemia</li>\n<li>Depression, fatigue, and sexual <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> such as <span class=\"customMeta\" data-dictid=\"5cc2a2112e16927771874c5d97065a\">erectile</span> dysfunction.</li>\n<li>Weight gain</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>First generation(Older / <span class=\"customMeta\" data-dictid=\"9996ef505516927771937fe4ef1222\">non</span> selective)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Second generation </strong></p>\n<p style=\"text-align:center\"><strong>(Cardioselective)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Third generation </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Propranolol <strong> </strong></li>\n<li>Sotalol</li>\n<li>Pindolol (100% bioavailability)</li>\n<li>Timolol</li>\n<li>Nadolol (Maximum t1/2)</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metoprolol</li>\n<li>Esmolol (Minimum t1/2)</li>\n<li>Atenolol</li>\n<li>Bisoprolol</li>\n<li>Acebutolol</li>\n<li> </li>\n<li> </li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With alpha-blocking activity</strong></p>\n<ul>\n<li>Labetalol</li>\n<li>Celiprolol</li>\n<li>Nebivolol</li>\n<li>Betaxolol</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockade</strong></p>\n<ul>\n<li>Carvedilol (maximum <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein binding )</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> 2 agonism </strong></p>\n<ul>\n<li>Bopindolol</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With K+ channel opening action</strong></p>\n<ul>\n<li>Tilisolol</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is correct regarding the mechanism of action of labetalol?", "options": [{"label": "A", "text": "Directly acts as arterial vasodilator resulting in indirect effect tachycardia", "correct": false}, {"label": "B", "text": "Blocks both alpha and beta-adrenergic receptors", "correct": false}, {"label": "C", "text": "Primarily acts as a vasodilator with little effect on arterioles", "correct": false}, {"label": "D", "text": "Decreases peripheral vascular resistance by directly acting as a relaxant for vascular smooth muscles", "correct": true}], "correct_answer": "D. Decreases peripheral vascular resistance by directly acting as a relaxant for vascular smooth muscles", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Blocks both &lt;span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\"&gt;alpha&lt;/span&gt; and &lt;span class=\"customMeta\" data-dictid=\"43f90e42341692777182f9e20606bb\"&gt;beta-adrenergic receptors&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Non selective 𝛃1 + 𝛃2 <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cardioselective 𝛃1 <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Without ISA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>With ISA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>With ɑ <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> activity</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<ul>\n<li>Metoprolol</li>\n<li>Esmolol</li>\n<li>Atenolol</li>\n<li>Bisoprolol</li>\n<li>Acebutolol</li>\n<li>Betaxolol</li>\n<li>Nebivolol</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Propranolol</li>\n<li>Sotalol</li>\n<li>Timolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pindolol</li>\n<li>Celiprolol</li>\n<li>Oxprenolol</li>\n<li>Penbutolol</li>\n<li>Pindolol</li>\n<li>Bopindolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Labetalol </strong></li>\n<li>Carvedilol</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Drug of choice for acute rheumatic fever?", "options": [{"label": "A", "text": "Digoxin", "correct": false}, {"label": "B", "text": "Aspirin", "correct": true}, {"label": "C", "text": "Amiodarone", "correct": false}, {"label": "D", "text": "Furosemide", "correct": false}], "correct_answer": "B. Aspirin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management of ARF</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment for</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication used</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group streptococcal infection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Penicillin/Erythromycin/Azithromycin.</li>\n<li>10 days or oral Amoxicillin or a single dose of IM benzathine penicillin.</li>\n<li>Azithromycin in case of <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">Penicillin</span> allergy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptomatic management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Salicylates like <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> (NSAIDs as an alternative option)</li>\n<li>It is the first-line treatment for <strong>arthritis</strong>, <strong>fever</strong>, and <strong>inflammation</strong>. Dose: High initially, then taper as symptoms improve.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carditis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corticosteroids.</li>\n<li>Diuretics like Furosemide are used if <strong>heart failure</strong> symptoms due to <strong>rheumatic <span class=\"customMeta\" data-dictid=\"7b028d193416927771835d48b193f9\">carditis</span> are present. </strong><strong>(Option D ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chorea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is managed conservatively, or Valproic acid is used for the sedation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CCF</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diuretics and vasodilators are used.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prophylaxis</strong></p>\n<p>(is essential to prevent <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> infections and further damage to the heart)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inj. Benzathine penicillin</strong> is given every 3-4 weeks IM</p>\n<ul>\n<li>6 lakh IU in children ≤27 kg.</li>\n<li>1.2 million IU in children &gt;27 kg</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bed rest is advised</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Major criteria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Minor criteria</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clinical or <span class=\"customMeta\" data-dictid=\"4e02cdf6641692777199b3cc3b7237\">subclinical</span> evidence of <span class=\"customMeta\" data-dictid=\"7b028d193416927771835d48b193f9\">carditis</span> (e.g., new murmur)</li>\n<li>Migratory <span class=\"customMeta\" data-dictid=\"943744d33e1692777196a18ed1b73c\">polyarthritis</span> (Two or more joints involved)</li>\n<li>Sydenham <span class=\"customMeta\" data-dictid=\"46ce506e9d1692777184f7a4a276ad\">chorea</span> (involuntary movements)</li>\n<li>Erythema marginatum (characteristic skin rash)</li>\n<li>Subcutaneous nodules</li>\n</ul>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Previous rheumatic fever or rheumatic heart disease</li>\n<li>Fever (≥38.5°C)</li>\n<li>Poly or mono arthralgia</li>\n<li>Elevated <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> phase reactants (e.g., CRP, ESR)</li>\n<li>Prolonged PR interval on ECG</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The presence of <strong>two major criteria</strong>, or <strong>one major <span class=\"customMeta\" data-dictid=\"9167b944ea169277718582367e0915\">criterion</span> + two minor criteria</strong> (along with evidence of preceding streptococcal infection), supports the diagnosis of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> rheumatic fever (ARF) according to the Jones criteria.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The true statement among the following is ___:", "options": [{"label": "A", "text": "Telmisartan dose should be reduced in renal failure but not in hepatic failure.", "correct": false}, {"label": "B", "text": "Irbesartan dose should be reduced in case of mild-moderate hepatic failure and renal failure.", "correct": false}, {"label": "C", "text": "Candesartan dose should be reduced in mild-moderate liver failure but not in renal failure.", "correct": false}, {"label": "D", "text": "Losartan acts as a thromboxane A2 antagonist and inhibits platelet aggregation.", "correct": true}], "correct_answer": "D. Losartan acts as a thromboxane A2 antagonist and inhibits platelet aggregation.", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Losartan </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Indications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypertension, <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> nephropathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Angiotension II <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypotension, hyperkalemia, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment, dizziness, fatigue, cough, headache, upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Contraindications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypersensitivity to losartan, pregnancy, breastfeeding</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug interactions </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Potassium supplements and other drugs that increase <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels, NSAIDs, diuretics, rifampin, ritonavir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dosage form</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tablets (25mg, 50mg, 100mg)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Route of administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oral</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Half-life </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1.5-2 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Precautions </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Use cautiously in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> and <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> impairment, heart failure, and aortic stenosis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a previous MI and ventricular arrhythmia is on treatment for a few months. He developed fatigue, dyspnea and weight gain. He had also developed pulmonary fibrosis. Which of the following drugs is responsible for this?", "options": [{"label": "A", "text": "Amiodarone", "correct": true}, {"label": "B", "text": "Atenolol", "correct": false}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Spironolactone", "correct": false}], "correct_answer": "A. Amiodarone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Amiodarone </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Prolonged <span class=\"customMeta\" data-dictid=\"1313ac90ca16927771807502911c57\">action potential</span> duration and QT interval by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> delayed <span class=\"customMeta\" data-dictid=\"294e2000571692777197bec3311923\">rectifier</span> K+ channels.</li>\n<li>Blocks inactivated Na<sup>+</sup> channels, with rapid channel recovery (Decrease <span class=\"customMeta\" data-dictid=\"a2ffa3fa8f1692777195ceee9dafdd\">phase 0</span> slope).</li>\n<li>Partially inhibits myocardial Ca<sup>2+</sup> channels, adding to its <span class=\"customMeta\" data-dictid=\"2f4652078816927771814621857a81\">antiarrhythmic</span> effects.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypotension and <span class=\"customMeta\" data-dictid=\"c933e533971692777183b764d960d0\">Bradycardia</span> (with i.v administration or after drug accumulation)</li>\n<li>Photosensitivity<strong>: </strong>Skin <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> - Purple color (Purple man syndrome, smurf syndrome)</li>\n<li><strong>Corneal microdeposits:</strong> <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">Reversible</span> upon drug discontinuation.</li>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"6e483e166a169277718133d060d311\">alveolitis</span> and <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> (On long-term use)</li>\n<li>Peripheral neuropathy</li>\n<li>Thyroid Dysfunction: Interfere with <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> function as it acts as a source of <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> and can potentially lead to goitre, <span class=\"customMeta\" data-dictid=\"8d4d1904791692777189941782330d\">hypothyroidism</span> <strong>(Wolf Chaikoff effect)</strong>, or, in rare cases, <span class=\"customMeta\" data-dictid=\"df46bcd43116927771892090901263\">hyperthyroidism</span> <strong>(Jos-Basedow effect).</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Inhibits CYP3A4, CYP2C9, and P-glycoprotein,</strong> leading to potential interactions with drugs metabolized by this system.</li>\n<li>Increases <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> levels of <span class=\"customMeta\" data-dictid=\"508c1bf22216927771860525d4ef6f\">digoxin</span> and warfarin.</li>\n<li>Additive <span class=\"customMeta\" data-dictid=\"78a0565f7316927771827e4aca866c\">AV block</span> with beta-blockers or <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channel blockers.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Below is an image of angiotensin II synthesis and neprilysin action with two arrows at ACE and Neprilysin. Which drug acts on both enzymes?", "options": [{"label": "A", "text": "Sacubitril", "correct": false}, {"label": "B", "text": "Omapatrilat", "correct": true}, {"label": "C", "text": "Losartan", "correct": false}, {"label": "D", "text": "Nesiritide", "correct": false}], "correct_answer": "B. Omapatrilat", "question_images": ["https://image.prepladder.com/notes/95M4fJNqeciBynK7lynN1745908351.png"], "explanation_images": ["https://image.prepladder.com/notes/pD5uXBMFun8FbnkPe7Lr1745908351.png"], "explanation": "<p>Correct Answer B - Omapatrilat </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Omapatrilat</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"PPH006\" data-author=\"NA\" data-hash=\"11372\" data-license=\"NA\" data-source=\"NA\" data-tags=\"April2025\" height=\"260\" src=\"https://image.prepladder.com/notes/pD5uXBMFun8FbnkPe7Lr1745908351.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Primarily for the treatment of <strong>hypertension</strong> and <strong>heart failure</strong><strong>.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Angioedema</strong></li>\n<li>Hypotension</li>\n<li>Cough</li>\n<li>Dizziness</li>\n<li>Fatigue</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented to the outpatient department with fatigue, and exertional and nocturnal dyspnoea. On examination, bilateral pedal oedema is noted. Auscultation reveals an S3 gallop and rales in both the lungs. Which of the following drugs can be used to prevent the progression of the disease?", "options": [{"label": "A", "text": "Verapamil", "correct": false}, {"label": "B", "text": "Digoxin", "correct": false}, {"label": "C", "text": "Captopril", "correct": true}, {"label": "D", "text": "Carvedilol", "correct": false}], "correct_answer": "C. Captopril", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old pregnant female presents to the emergency department with a BP of 220/120mm Hg, along with headache, seizure, and blurred vision. Which of the following is the preferred intravenous medication for the management of hypertension in pregnancy?", "options": [{"label": "A", "text": "IV Labetalol", "correct": true}, {"label": "B", "text": "IV nitroglycerine", "correct": false}, {"label": "C", "text": "IV hydralazine", "correct": false}, {"label": "D", "text": "IV sodium nitroprusside", "correct": false}], "correct_answer": "A. IV Labetalol", "question_images": [], "explanation_images": [], "explanation": "\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Beta-blockers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Labetalol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Preferred. Generally safe and effective</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Calcium channel blockers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Nifedipine</strong></p>\n<p><strong>Amlodipine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Safe, less BP <span class=\"customMeta\" data-dictid=\"128186f064169277720116e786798a\">variability</span> compared to labetalol</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vasodilators</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hydralazine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reserved for cases with cardiac/renal dysfunction</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>ACE inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Enalapril, Lisinopril</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Associated with severe <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> malformations</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Angiotensin-receptor blockers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Losartan, Valsartan</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Not recommended at any point during pregnancy</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male patient with a history of hyperlipidemia was started on statins for elevated triglyceride levels. Despite the statin therapy, his triglycerides remain persistently elevated at over 600 mg/dL. Which of the following medications should be administered next to help manage the triglyceride levels?", "options": [{"label": "A", "text": "Fibrates", "correct": true}, {"label": "B", "text": "Niacin", "correct": false}, {"label": "C", "text": "Statins", "correct": false}, {"label": "D", "text": "Resins", "correct": false}], "correct_answer": "A. Fibrates", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the best drug to reduce LDL cholesterol levels?", "options": [{"label": "A", "text": "Niacin", "correct": false}, {"label": "B", "text": "Fibrates", "correct": false}, {"label": "C", "text": "Statins", "correct": true}, {"label": "D", "text": "Resins", "correct": false}], "correct_answer": "C. Statins", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>LDL-C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Total TG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>HDL</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Statins</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Decreases (maximum)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Mild reduction</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Increase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Resin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Decreases</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">increases</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">No effect</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fibrates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Decreases</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Maximum reduction</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Increases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Niacin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Decreases</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Reduced (almost 50%)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Maximum increase</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following GPCRs does not act via the K + channel ?", "options": [{"label": "A", "text": "Angiotensin 1 receptor", "correct": true}, {"label": "B", "text": "Muscarinic M2 receptor", "correct": false}, {"label": "C", "text": "Dopamine D2 receptor", "correct": false}, {"label": "D", "text": "Serotonin 5 HT 1 receptor", "correct": false}], "correct_answer": "A. Angiotensin 1 receptor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"c4d00ed86c1692777181c0c43a452a\"&gt;Angiotensin&lt;/span&g\n<table border=\"1\">\n<thead>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Transmembrane receptors that transmit signals through G-proteins.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Activation Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Ligand binding (hormones, neurotransmitters, etc.) causes conformational changes in the receptor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>G-Protein Activation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Ligand-bound <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> activates G-protein by promoting exchange of <span class=\"customMeta\" data-dictid=\"3cd497bfd7169277718814b61749b9\">GDP</span> for GTP.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>G-Protein Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>G-proteins are divided into three classes: Gs, Gi/o, and Gq.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>G-Protein Functions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Gs stimulates <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> cyclase, increasing cAMP levels.</p>\n</li>\n<li>\n<p>Gi/o inhibits <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> cyclase, reducing cAMP levels.</p>\n</li>\n<li>\n<p>Gq activates <span class=\"customMeta\" data-dictid=\"b3c0aa468916927771955a8c6d6998\">phospholipase</span> C, leading to IP3 and <span class=\"customMeta\" data-dictid=\"ffd1412fed1692777185cd107f3835\">DAG</span> production.</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Second Messengers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>cAMP, IP3, DAG, <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> ions, and others depending on the pathway.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Downstream <span class=\"customMeta\" data-dictid=\"f9016f36fd1692777198b0fd5e9c6d\">Signaling</span> Pathways</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Activation of kinases, phosphatases, <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> channels, and more.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Diversity of GPCRs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>&gt;800 GPCRs in humans, regulating diverse <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> processes.</p>\n</li>\n<li>\n<p>Organized into families based on sequence homology.</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Tissue Distribution</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>GPCRs are present in virtually all cell types and tissues.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Drug Targets</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Many drugs target GPCRs for <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> purposes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Examples of <span class=\"customMeta\" data-dictid=\"abaeb5c732169277718823c694a755\">GPCR</span> Ligands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>\n<p>Adrenaline (β-adrenergic receptors)</p>\n</li>\n<li>\n<p>Serotonin (5-HT receptors)</p>\n</li>\n<li>\n<p>Acetylcholine (muscarinic receptors)</p>\n</li>\n<li>\n<p>Histamine (histamine receptors)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Signal Termination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Ligand dissociates from the receptor, G-protein hydrolyzes <span class=\"customMeta\" data-dictid=\"74ea5b4482169277718880d098514c\">GTP</span> to GDP, and system returns to <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> state.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Regulation of GPCRs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Desensitization, internalization, and recycling of receptors to control responsiveness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Importance in <span class=\"customMeta\" data-dictid=\"955afd17541692777195b119746b97\">Physiology</span> and Medicine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p>Critical in regulating diverse processes: neurotransmission, hormone release, immune response, etc.</p>\n</td>\n</tr>\n</thead>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Propranolol is drug of choice for:", "options": [{"label": "A", "text": "Ulcerated infantile hemangioma", "correct": true}, {"label": "B", "text": "Lymphangioma circumscriptum", "correct": false}, {"label": "C", "text": "Capillary malformation", "correct": false}, {"label": "D", "text": "Pyogenic granuloma", "correct": false}], "correct_answer": "A. Ulcerated infantile hemangioma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ulcerated &lt;span class=\"customMeta\" data-dictid=\"4c815174781692777190e1b4a5d704\"&gt;infantile&lt;/span&gt; hemang\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication is known to induce orthostatic (postural) hypotension and may lead to potentially severe blood pressure drops when patients transition from sitting or lying down to a standing position, potentially causing dizziness, lightheadedness, or even fainting?", "options": [{"label": "A", "text": "Metformin", "correct": false}, {"label": "B", "text": "Prazosin", "correct": true}, {"label": "C", "text": "Acarbose", "correct": false}, {"label": "D", "text": "Nor-adrenaline", "correct": false}], "correct_answer": "B. Prazosin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - P\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alpha-1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> blockers</p>\n</td>\n<td>\n<p>Prazosin, Terazosin, Doxazosin</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alpha-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> agonists</p>\n</td>\n<td>\n<p>Clonidine, Methyldopa</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Calcium channel blockers</p>\n</td>\n<td>\n<p>Amlodipine, Nifedipine, Verapamil</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>ACE inhibitors</p>\n</td>\n<td>\n<p>Lisinopril, Enalapril, Ramipril</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Angiotensin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blockers</p>\n</td>\n<td>\n<p>Losartan, Valsartan, Irbesartan</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Diuretics</p>\n</td>\n<td>\n<p>Hydrochlorothiazide, Furosemide</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antidepressants</p>\n</td>\n<td>\n<p>Tricyclic antidepressants (e.g., Amitriptyline), Selective <span class=\"customMeta\" data-dictid=\"06eba971ce169277719884f8c62937\">serotonin</span> <span class=\"customMeta\" data-dictid=\"42c441fad11692777197258f322307\">reuptake</span> inhibitors (SSRIs)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antipsychotics</p>\n</td>\n<td>\n<p>Haloperidol, Risperidone, Quetiapine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Sedative-hypnotics</p>\n</td>\n<td>\n<p>Benzodiazepines (e.g., Diazepam), Z-drugs (e.g., Zolpidem)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Opioids</p>\n</td>\n<td>\n<p>Morphine, Oxycodone, Codeine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Anti-Parkinson's agents</p>\n</td>\n<td>\n<p>Levodopa, <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">Dopamine</span> agonists (e.g., Pramipexole)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nonsteroidal anti-inflammatory drugs (NSAIDs)</p>\n</td>\n<td>\n<p>Ibuprofen, Naproxen</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antihistamines</p>\n</td>\n<td>\n<p>Diphenhydramine, Chlorpheniramine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Isosorbide dinitrate is indicated for congestive heart failure in combination with which of the following vasodilators ?", "options": [{"label": "A", "text": "Minoxidil", "correct": false}, {"label": "B", "text": "Hydralazine", "correct": true}, {"label": "C", "text": "Nimodipine", "correct": false}, {"label": "D", "text": "Nitrendipine", "correct": false}], "correct_answer": "B. Hydralazine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - H\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of sodium nitroprusside ?", "options": [{"label": "A", "text": "Increased cAMP", "correct": false}, {"label": "B", "text": "Stimulation of gunaylyl cyclase", "correct": true}, {"label": "C", "text": "Calcium channel blockage", "correct": false}, {"label": "D", "text": "K + channel opener", "correct": false}], "correct_answer": "B. Stimulation of gunaylyl cyclase", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\"&gt;Stimulation&lt;/span&gt; of &lt;span class=\"customMeta\" data-dictid=\"69ea502f9316927771884f58d6fad1\"&gt;guanylyl&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of sacubitril, a newly approved drug for the treatment of chronic heart failure?", "options": [{"label": "A", "text": "Angiotensin II inhibitor", "correct": false}, {"label": "B", "text": "ACE inhibitor", "correct": false}, {"label": "C", "text": "Renin inhibitor", "correct": false}, {"label": "D", "text": "Neutral endopeptidase inhibitor", "correct": true}], "correct_answer": "D. Neutral endopeptidase inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Neutral &lt;span class=\"customMeta\" data-dictid=\"448b58259f1692777187206caa1c8f\"&gt;endopeptidase&lt;/span&gt; inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is associated with QT prolongation ?", "options": [{"label": "A", "text": "Lignocaine", "correct": false}, {"label": "B", "text": "Quinidine", "correct": true}, {"label": "C", "text": "Magnesium sulfate", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "B. Quinidine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Qu\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Antiarrhythmics</strong></p>\n</td>\n<td>\n<p>Quinidine, Procainamide, Amiodarone, Sotalol</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Antibiotics</strong></p>\n</td>\n<td>\n<p>Erythromycin, Fluoroquinolones, Ciprofloxacin, Bedaquilline, Delamanid, Pretomanid</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Antidepressants</strong></p>\n</td>\n<td>\n<p>Amitriptyline, Desipramine, Doxepin, Fluoxetine, Sertraline, Venlafaxine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Antipsychotics</strong></p>\n</td>\n<td>\n<p>Haloperidol, Thioridazine, Quetiapine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Antiemetics</strong></p>\n</td>\n<td>\n<p>Dolasetron</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Opioids</strong></p>\n</td>\n<td>Methadone</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who is on treatment for angina, presents to you with erectile dysfunction. You decide against prescribing sildenafil because the patient is being treated with ____________:", "options": [{"label": "A", "text": "Calcium channel blockers", "correct": false}, {"label": "B", "text": "Beta blockers", "correct": false}, {"label": "C", "text": "Nitrates", "correct": true}, {"label": "D", "text": "ACE inhibitors", "correct": false}], "correct_answer": "C. Nitrates", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - N\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs causes activation of K+-ATP channels ?", "options": [{"label": "A", "text": "Nicorandil", "correct": true}, {"label": "B", "text": "Molsidomine", "correct": false}, {"label": "C", "text": "Isosorbide dinitrate", "correct": false}, {"label": "D", "text": "Nitroglycerin", "correct": false}], "correct_answer": "A. Nicorandil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - N\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A hypertensive patient was started on some anti-hypertensive drug but he developed a dry cough . Which of the following drug can be responsible for this effect?", "options": [{"label": "A", "text": "Calcium channel blockers", "correct": false}, {"label": "B", "text": "Beta blockers", "correct": false}, {"label": "C", "text": "ACE inhibitors", "correct": true}, {"label": "D", "text": "Diuretics", "correct": false}], "correct_answer": "C. ACE inhibitors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 44-year-old male was admitted to the ICU after being diagnosed with Subarachnoid hemorrhage secondary to a ruptured aneurysm . The patient is a known case of stage 2 hypertension and was taking Ramipril for the same. Which of the following calcium channel blockers can be used in this case, which might help relieve the cerebral vasospasm?", "options": [{"label": "A", "text": "Nimodipine", "correct": true}, {"label": "B", "text": "Felodipine", "correct": false}, {"label": "C", "text": "Amlodipine", "correct": false}, {"label": "D", "text": "Nitrendipine", "correct": false}], "correct_answer": "A. Nimodipine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - N\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Drug of choice for paroxysmal supraventricular tachycardia is:", "options": [{"label": "A", "text": "Digoxin", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Adenosine", "correct": true}, {"label": "D", "text": "Dilitiazem", "correct": false}], "correct_answer": "C. Adenosine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Preferred drug for the treatment of ventricular tachycardia is:", "options": [{"label": "A", "text": "Digoxin", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Lignocaine", "correct": true}], "correct_answer": "D. Lignocaine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Lig\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What medications should be administered to manage a patient who is 34 weeks pregnant and experiencing seizures, with a blood pressure reading of 200/110 mmHg?", "options": [{"label": "A", "text": "Oral Labetalol", "correct": false}, {"label": "B", "text": "IV labetalol plus magnesium sulphate", "correct": true}, {"label": "C", "text": "IV Lorazepam", "correct": false}, {"label": "D", "text": "IV Enalapril", "correct": false}], "correct_answer": "B. IV labetalol plus magnesium sulphate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - IV &lt;span class=\"customMeta\" data-dictid=\"5729c1fa1a16927771912963eea9a2\"&gt;labetalol&lt;/span&gt; plus &lt;span class=\"customMeta\" data-dictid=\"4d7ed0baae169277719199f6e9ab7b\"&gt;magnesium&lt;/span&gt; sulph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not used in heart failure ?", "options": [{"label": "A", "text": "Trimetazidine", "correct": true}, {"label": "B", "text": "Sacubitril", "correct": false}, {"label": "C", "text": "Metoprolol", "correct": false}, {"label": "D", "text": "Nesiritide", "correct": false}], "correct_answer": "A. Trimetazidine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - T\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\">ACE Inhibitors</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Lisinopril, Enalapril</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Angiotensin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Blockers</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Losartan, Valsartan</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Beta-Blockers</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Metoprolol, Carvedilol</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Mineralocorticoid <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonists</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Spironolactone, Eplerenone</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Diuretics</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Furosemide, Hydrochlorothiazide</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Digoxin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">-</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Sacubitril/Valsartan (ARNI)</p>\n</td>\n<td>\n<p style=\"text-align: center;\">-</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Ivabradine</p>\n</td>\n<td>\n<p style=\"text-align: center;\">-</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Hydralazine/Isosorbide Dinitrate</p>\n</td>\n<td>\n<p style=\"text-align: center;\">-</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 53 year old man is found to have stage 2 hypertension without any co morbidities . Which drug will you start ?", "options": [{"label": "A", "text": "Furosemide", "correct": false}, {"label": "B", "text": "Chlorthalidone", "correct": true}, {"label": "C", "text": "Spironolactone", "correct": false}, {"label": "D", "text": "Triamterene", "correct": false}], "correct_answer": "B. Chlorthalidone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Chlorthalidone: \n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Medication</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Indication in Hypertension</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p><strong>Chlorthalidone</strong></p>\n</td>\n<td>\n<p>Initial choice for stage 2 <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> without co-morbidities</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Spironolactone</strong></p>\n</td>\n<td>\n<p>Often used as <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> therapy or for additional <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> control</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Triamterene</strong></p>\n</td>\n<td>\n<p>Not typically used as initial <span class=\"customMeta\" data-dictid=\"e26d71db351692777192bd4e95fc68\">monotherapy</span> for hypertension</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs does not reduce mortality in patients with heart failure with reduced ejection fraction (HFrEF)?", "options": [{"label": "A", "text": "Digoxin", "correct": true}, {"label": "B", "text": "Beta-blockers", "correct": false}, {"label": "C", "text": "ACE inhibitors", "correct": false}, {"label": "D", "text": "Hydralazine + isosorbide dinitrate", "correct": false}], "correct_answer": "A. Digoxin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Dig\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 73 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 70-year-old woman came with complaints of sudden onset of pain, swelling, and redness in her left calf. She has been experiencing difficulty walking and standing for the past two days. She has a history of hypertension and high cholesterol, which is being managed with diet and medication. On giving which of the following drugs will we need to monitor her clotting time for?", "options": [{"label": "A", "text": "Aspirin", "correct": false}, {"label": "B", "text": "Heparin", "correct": true}, {"label": "C", "text": "Alteplase", "correct": false}, {"label": "D", "text": "Apixaban", "correct": false}], "correct_answer": "B. Heparin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UurFmSyBXU8bYvCEfnmH1724134747.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old female patient with a history of atrial fibrillation visits for routine follow-up. She has been prescribed an antiplatelet drug to reduce her risk of stroke. Her medication regimen includes clopidogrel, which she has been taking for the past six months without any adverse effects. Which receptor is primarily targeted by clopidogrel to inhibit platelet aggregation?", "options": [{"label": "A", "text": "P2Y12 receptor", "correct": true}, {"label": "B", "text": "GP IIb/IIIa receptor", "correct": false}, {"label": "C", "text": "COX-1 enzyme", "correct": false}, {"label": "D", "text": "Thrombin receptor", "correct": false}], "correct_answer": "A. P2Y12 receptor", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/bavUtsN4bL6Ip91rJg7y1724134811.jpg", "https://image.prepladder.com/content/rgeRMbiKRxTf6gIZGjK11724134847.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male presents with acute chest pain suggestive of MI. He has a history of hypertension, hyperlipidemia, and type 2 diabetes mellitus. Which of the following is the most appropriate initial dose of aspirin for this patient?", "options": [{"label": "A", "text": "75 mg orally", "correct": false}, {"label": "B", "text": "150 mg orally", "correct": false}, {"label": "C", "text": "325 mg orally", "correct": true}, {"label": "D", "text": "500 mg orally", "correct": false}], "correct_answer": "C. 325 mg orally", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old female patient with a history of atrial fibrillation and coronary artery disease is scheduled for elective hip replacement surgery in two weeks. She has been taking low-dose aspirin (75 mg daily) for secondary prevention of MI and stroke. Which of the following is the most appropriate management regarding her aspirin therapy before surgery?", "options": [{"label": "A", "text": "Continue aspirin at the same dose through the surgery.", "correct": false}, {"label": "B", "text": "Stop aspirin immediately and resume after the surgery.", "correct": false}, {"label": "C", "text": "Stop aspirin 7-10 days before surgery and resume after the surgery.", "correct": true}, {"label": "D", "text": "Switch from aspirin to clopidogrel until after the surgery.", "correct": false}], "correct_answer": "C. Stop aspirin 7-10 days before surgery and resume after the surgery.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/GiT9ngXjjZX7g8wYIWm11724134968.jpg"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male with a history of hypertension and type 2 diabetes presents with chest pain and is diagnosed with acute coronary syndrome. The cardiology team decides to initiate antiplatelet therapy. Which of the following ADP receptor blockers would be the best choice if the team wants an agent with reversible action?", "options": [{"label": "A", "text": "Vorapaxar", "correct": false}, {"label": "B", "text": "Prasugrel", "correct": false}, {"label": "C", "text": "Ticagrelor", "correct": true}, {"label": "D", "text": "Ticlopidine", "correct": false}], "correct_answer": "C. Ticagrelor", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Irreversible blockers (prodrugs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reversible blockers (active drugs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ticlodipine.<strong>(Option D)</strong></li>\n<li>Clopidogrel</li>\n<li>Prasugrel.<strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ticagrelor.</li>\n<li>Cangrelor: IV drug (used during <span class=\"customMeta\" data-dictid=\"b2fb1a3a5416927771953ea4fa15e1\">percutaneous</span> <span class=\"customMeta\" data-dictid=\"7c48bba0a71692777200073b077d94\">transluminal</span> <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> angiography- PTCA).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old man presents with a sudden onset of severe chest pain radiating to his left arm. He is diaphoretic and appears anxious. His medical history includes hypertension and hyperlipidemia. An ECG shows ST-segment elevation in the anterior leads, and laboratory tests reveal elevated troponin levels. The cardiologist considers initiating therapy with prasugrel. Which of the following conditions is a contraindication for the use of prasugrel in this patient?", "options": [{"label": "A", "text": "Hypertension", "correct": false}, {"label": "B", "text": "Hyperlipidemia", "correct": false}, {"label": "C", "text": "History of ischemic stroke", "correct": true}, {"label": "D", "text": "Diabetes mellitus", "correct": false}], "correct_answer": "C. History of ischemic stroke", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male with a history of stable angina is currently on a regimen that includes aspirin and nitrates. His cardiologist decides to add a new medication to his treatment plan to prevent thrombotic events further. After a few weeks, the patient reports increased episodes of chest pain, particularly during physical exertion. The cardiologist suspects that it might be coronary steal syndrome. Which of the following medications is most likely responsible?", "options": [{"label": "A", "text": "Pentoxifylline", "correct": false}, {"label": "B", "text": "Dipyridamole", "correct": true}, {"label": "C", "text": "Cilostazol", "correct": false}, {"label": "D", "text": "Aspirin", "correct": false}], "correct_answer": "B. Dipyridamole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pentoxifylline</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p>Used as an add-on drug to <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> in cases of Stroke and Buerger's disease</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li> Improves blood <span class=\"customMeta\" data-dictid=\"337d16dac5169277718474b97f6e4a\">circulation</span> (rheological agent)</li>\n<li> Increases <span class=\"customMeta\" data-dictid=\"d6c754309d16927771874142ec8ca4\">elasticity</span> of RBCs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cilostazol</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">-</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dipyridamole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> Dipyridamole is approved for secondary prevention of stroke when it is combined with aspirin</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male with a history of myocardial infarction is being evaluated for ongoing chest pain and shortness of breath. The patient's current medication regimen includes aspirin, a beta-blocker, and a statin. The cardiologist considers adding a Phosphodiesterase 3 (PDE-3) inhibitor to further manage the patient's symptoms but recalls that certain PDE-3 inhibitors are contraindicated in patients with myocardial infarction. Which is the correct reason for PDE-3 inhibitors being contraindicated in patients with a history of myocardial infarction?", "options": [{"label": "A", "text": "They increase the risk of bleeding.", "correct": false}, {"label": "B", "text": "They cause severe hypotension.", "correct": false}, {"label": "C", "text": "They may inhibit PDE3 in the heart, leading to increased cardiac stimulation and oxygen demand.", "correct": true}, {"label": "D", "text": "They can cause bradycardia and heart block.", "correct": false}], "correct_answer": "C. They may inhibit PDE3 in the heart, leading to increased cardiac stimulation and oxygen demand.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old male patient with a history of chronic kidney disease presents to the emergency department with severe chest pain. An electrocardiogram (ECG) confirms an acute myocardial infarction (MI). The cardiologist decides to proceed with percutaneous coronary intervention (PCI) and considers using a glycoprotein IIb/IIIa inhibitor to prevent further thrombotic events during the procedure. Given the patient's renal condition, which glycoprotein IIb/IIIa inhibitor is most appropriate for this patient?", "options": [{"label": "A", "text": "Eptifibatide", "correct": false}, {"label": "B", "text": "Abciximab", "correct": true}, {"label": "C", "text": "Tirofiban", "correct": false}, {"label": "D", "text": "Aspirin", "correct": false}], "correct_answer": "B. Abciximab", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">GpIIb/IIIa inhibitors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Structure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Common Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Route</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Abciximab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Monoclonal antibody</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Acute attack of MI</p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\">Stroke</p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\">Stent replacement <strong>(Percutaneous <span class=\"customMeta\" data-dictid=\"7c48bba0a71692777200073b077d94\">transluminal</span> <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> angioplasty)</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><br/>\n\t\t\t </p>\n<p style=\"text-align:center\">i.v.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Eptifibatide</p>\n<p style=\"text-align:center\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Peptide molecule</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Tirofiban</p>\n<p style=\"text-align:center\"><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Non-peptide molecule</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about newer antiplatelet drugs is incorrect?", "options": [{"label": "A", "text": "Vorapaxar is a PAR (Protease Activating Receptor) inhibitor.", "correct": false}, {"label": "B", "text": "Blocking PAR receptors on platelets prevents the attachment of thrombin, leading to no platelet aggregation.", "correct": false}, {"label": "C", "text": "Dazoxiben is a thromboxane A2 synthase inhibitor.", "correct": false}, {"label": "D", "text": "Dazoxiben is recently approved as an add-on drug to aspirin in myocardial infarction (MI).", "correct": true}], "correct_answer": "D. Dazoxiben is recently approved as an add-on drug to aspirin in myocardial infarction (MI).", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Approval Status</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Vorapaxar</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">PAR (Protease Activating Receptor) inhibitor</p>\n<p style=\"text-align:center\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Blocks <span class=\"customMeta\" data-dictid=\"bb9e0041f71692777194e60188e1b6\">PAR</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> on platelets, preventing <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> <span class=\"customMeta\" data-dictid=\"ccd357daaf16927771825777ea6a0d\">attachment</span> and <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> aggregation</p>\n<p style=\"text-align:center\"><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Recently approved as an add-on drug to <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> in MI</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Dazoxiben</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Thromboxane A2 <span class=\"customMeta\" data-dictid=\"d2bd91ccac169277719941254e1795\">synthase</span> inhibitor</p>\n<p style=\"text-align:center\"><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Arachidonic Acid (via COX-1 enzyme)</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Prostaglandin G2 (via <span class=\"customMeta\" data-dictid=\"96309dcb1c169277720072ad555473\">Thromboxane</span> A2 Synthase)</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Thromboxane A2 (TxA2)</p>\n<p style=\"text-align:center\">Dazoxiben blocks <strong>Thromboxane A2 Synthase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Under trial for MI</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female presents to the clinic with a history of easy bruising, petechiae, and prolonged bleeding from minor cuts. Laboratory tests reveal a significantly low platelet count, and she is diagnosed with idiopathic thrombocytopenic purpura (ITP). The physician decides to start treatment to increase her platelet count. Which of the following pro-platelet drugs is most appropriate for treating this patient's condition?", "options": [{"label": "A", "text": "Vorapaxar", "correct": false}, {"label": "B", "text": "Oprelvekin", "correct": false}, {"label": "C", "text": "Romiplostim", "correct": true}, {"label": "D", "text": "Abciximab", "correct": false}], "correct_answer": "C. Romiplostim", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pro-Platelet Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Route</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Romiplostim</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Recombinant <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of thrombopoietin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Subcutaneous injection</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Treatment of <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> thrombocytopenic <span class=\"customMeta\" data-dictid=\"0acd34c758169277719644923511e5\">purpura</span> (ITP)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Eltrombopag</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Thrombopoietin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Treatment of <span class=\"customMeta\" data-dictid=\"57ddcfb8ec1692777190b76f23c2e5\">ITP</span> and chronic liver disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Oprelvekin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Recombinant <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of IL-11</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Subcutaneous injection</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">DOC in chemotherapy-induced thrombocytopenia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UaYbEHuq5O63XxfbY7f41747297647.mp3", "video": ""}, {"text": "Which of the following drugs is approved for immune thrombocytopenia (ITP) ?", "options": [{"label": "A", "text": "Fostamatinib", "correct": true}, {"label": "B", "text": "Bosutinib", "correct": false}, {"label": "C", "text": "Oprelvekin", "correct": false}, {"label": "D", "text": "Erlotinib", "correct": false}], "correct_answer": "A. Fostamatinib", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fostamatinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BTK inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic immune thrombocytopenia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bosutinib</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tyrosine <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic, accelerated, or blast-phase Ph+ <span class=\"customMeta\" data-dictid=\"32c39405871692777184d06d6c01ab\">CML</span> with resistance or <span class=\"customMeta\" data-dictid=\"7794e5fd7a1692777190ee626ede62\">intolerance</span> to prior therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oprelvekin</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thrombopoietic growth factor (recombinant IL-11)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Patients undergoing <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> for non-myeloid malignancies with severe thrombocytopenia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erlotinib</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>EGFR inhibitor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Patients with advanced or metastatic Non-Small Cell Lung Cancer after failure of platinum-based <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> treatment</li>\n</ul>\n<ul>\n<li>Newly diagnosed Non-Small Cell Lung Cancer patients with EGFR mutations</li>\n<li>In combination with gemcitabine for the treatment of patients with locally advanced, unresectable, or metastatic pancreatic cancer</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following features of iron dextran is NOT true?", "options": [{"label": "A", "text": "It can be administered intravenously (IV) or intramuscularly (IM).", "correct": false}, {"label": "B", "text": "It is useful for patients with chronic gastrointestinal blood loss.", "correct": false}, {"label": "C", "text": "Staining of subcutaneous fat can occur with IM injections", "correct": false}, {"label": "D", "text": "Allergy testing is not required before administration.", "correct": true}], "correct_answer": "D. Allergy testing is not required before administration.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:745px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Parenteral Iron Formulation</strong></p>\n<p style=\"text-align: center;\"><strong>&amp; ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Anaphylaxis </strong></p>\n<p style=\"text-align: center;\"><strong>Risk</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Disadvantages</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Iron dextran</strong></p>\n<p style=\"text-align: center;\">(IV, IM)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">Yes</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:middle\">\n<p style=\"text-align: center;\">Useful for patients with chronic <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> blood loss.</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Subcutaneous fat <span class=\"customMeta\" data-dictid=\"3b007026bd16927771997ae809b603\">staining</span> with IM injections (Z-track technique helps prevent staining)</li>\n<li>Allergy testing required before administration</li>\n<li>Not preferred in <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">rheumatoid</span> <span class=\"customMeta\" data-dictid=\"6f74c7bfe0169277718240005b59d1\">arthritis</span> or <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue diseases</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Iron <span class=\"customMeta\" data-dictid=\"09b11c18721692777198957d597ccc\">sorbitol</span> </strong>citrate</p>\n<p style=\"text-align: center;\">(IM)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">Yes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Iron sucrose</strong></p>\n<p style=\"text-align: center;\">(IV)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">No</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">Safer than iron dextran.</p>\n<p style=\"text-align: center;\">Indicated for <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> in patients with <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease.</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Total dose IV <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> not possible</li>\n<li>Reports of <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> damage exist</li>\n<li>Avoid oral iron concurrently and for 5 days after the last injection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ferric gluconate</strong></p>\n<p style=\"text-align: center;\">(IV)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">No</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\">About 80% is delivered to <span class=\"customMeta\" data-dictid=\"d404d819f41692777200b686a0759e\">transferrin</span> within 24 hours</p>\n<p style=\"text-align: center;\">Safer than iron dextran</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:396px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Oral</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sulphate, Gluconate, Ascorbate</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>IM</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sorbitol, Polymaltose, Dextran</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>IV</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Sucrose (Most common), Carboxymaltose (Best), Dextran</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RUw9aJceuLTRooDf6aPB1749108928.mp3", "video": ""}, {"text": "A 55-year-old male patient with CKD presents complaining of persistent fatigue and weakness. Labs reveal anaemia. After assessing the patient's medical history and conducting further investigations, the physician decides to prescribe an erythropoiesis-stimulating agent to manage the anaemia associated with CKD. Which of the following is the longest-acting erythropoietin analogue?", "options": [{"label": "A", "text": "Epoetin alfa", "correct": false}, {"label": "B", "text": "Darbepoetin", "correct": false}, {"label": "C", "text": "Peginesatide", "correct": true}, {"label": "D", "text": "Daprodustat", "correct": false}], "correct_answer": "C. Peginesatide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dosing Frequency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Half-life</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epoetin alfa</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recombinant human EPO</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1–3 times/week</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~8 hours (IV), ~24 h (SC)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Darbepoetin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Modified EPO with added <span class=\"customMeta\" data-dictid=\"a78d5d70401692777198a285e3467a\">sialic</span> acid</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Weekly to biweekly</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~21–49 hours (SC)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peginesatide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pegylated <span class=\"customMeta\" data-dictid=\"61fbe2173416927771998e7aa0b432\">synthetic</span> EPO <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Once monthly (longest-acting)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>~130 hours</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Daprodustat</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral HIF-PH <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (not EPO analog)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Daily oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~3–5 hours</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8c2Pd6Sqol3cTKU3Isx31748863711.mp3", "video": ""}, {"text": "A 45-year-old male patient with non-Hodgkin's lymphoma is undergoing high-dose chemotherapy. Post-chemotherapy, he develops severe neutropenia. His oncologist decides to use a hematopoietic drug to stimulate neutrophil production. Which of the following treatments is most appropriate for managing his condition?", "options": [{"label": "A", "text": "Erythropoietin", "correct": false}, {"label": "B", "text": "Vitamin B12 and folic acid", "correct": false}, {"label": "C", "text": "Filgrastim", "correct": true}, {"label": "D", "text": "Plerixafor", "correct": false}], "correct_answer": "C. Filgrastim", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:784px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G-CSF</strong></p>\n<p>(Glycoprotein with 175 <span class=\"customMeta\" data-dictid=\"543f207eb51692777181723491a358\">amino</span> acids)</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Stimulates colony forming unit (CFU) granulocytes to increase <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production.</li>\n<li>Enhances <span class=\"customMeta\" data-dictid=\"b68a8f1b37169277719547f1cfda59\">phagocytic</span> and cytotoxic activities of neutrophils</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treats severe <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> after <span class=\"customMeta\" data-dictid=\"0a266da66816927771824d58668832\">autologous</span> <span class=\"customMeta\" data-dictid=\"d2e0ab499c169277718886ab5a46bf\">hematopoietic</span> <span class=\"customMeta\" data-dictid=\"467c0b4fc016927771997e1043aeda\">stem cell transplantation</span> and high-dose cancer chemotherapy</li>\n<li>Treats severe <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> neutropenias</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Filgrastim</strong></p>\n<p>(Recombinant human G-CSF)</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Same use as G-CSF</li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> in patients with AIDS receiving zidovudine</li>\n<li>Used in patients undergoing <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood stem cells collection for stem cell transplantation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>PEG-Filgrastim</strong></p>\n<p>(Longer acting <span class=\"customMeta\" data-dictid=\"761475dbbd169277719523f180ef28\">pegylated</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of G-CSF)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevention of chemotherapy-induced neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sargramostim</strong></p>\n<p>(Recombinant human GM-CSF)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stimulates myelopoiesis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Autologous <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> <span class=\"customMeta\" data-dictid=\"ee9f07b0a81692777200e416e4e5d7\">transplantation</span> treatment</li>\n<li>Mobilizes CD34+ progenitor cells for <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood stem cell collection post-myeloablative chemotherapy</li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> in patients on <span class=\"customMeta\" data-dictid=\"901bf573f216927771905f0abedca2\">intensive</span> cancer chemotherapy</li>\n<li>Supports <span class=\"customMeta\" data-dictid=\"9a34416acd16927771930416df6115\">myelopoiesis</span> in <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> neutropenia, myelodysplasia, <span class=\"customMeta\" data-dictid=\"1ea06afcbd1692777181199bfa3300\">aplastic</span> anemia, and AIDS-associated neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Molgramostim</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targets <span class=\"customMeta\" data-dictid=\"7d1066832b16927771883681f74869\">GM-CSF</span> receptors on <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> <span class=\"customMeta\" data-dictid=\"ae13cdc5c3169277719683e9f6bda5\">precursor</span> cells</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases granulocytes and monocytes</li>\n<li>Approved for chemotherapy-induced neutropenia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BWiuzpdrla7lLG3VRPtz1749108551.mp3", "video": ""}, {"text": "A 60-year-old male patient with chronic hepatitis C is scheduled to undergo a liver biopsy. He has a history of thrombocytopenia, with a platelet count of 45,000/µL, which poses a risk for bleeding during the procedure. His hepatologist decides to use a pharmacological agent to increase his platelet count before the surgery. Which of the following treatments is most appropriate to achieve this goal?", "options": [{"label": "A", "text": "Romiplostim", "correct": false}, {"label": "B", "text": "Eltrombopag", "correct": true}, {"label": "C", "text": "Erythropoietin", "correct": false}, {"label": "D", "text": "IV IG (Intravenous Immunoglobulin)", "correct": false}], "correct_answer": "B. Eltrombopag", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:579px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common cause</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersplenism and decreased <span class=\"customMeta\" data-dictid=\"b084a2ed0d1692777200e64e4a9b54\">thrombopoietin</span> due to liver dysfunction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk in biopsy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bleeding risk increased if platelets &lt; 50,000/µL</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preferred drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eltrombopag</strong> (oral) or <strong>Lusutrombopag</strong>, both raise <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> count</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Onset of action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>~10–14 days; used pre-procedure</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Temporary <span class=\"customMeta\" data-dictid=\"a1f256489a16927771870ddd296574\">elevation</span> before high-risk procedures</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JIKkNsOWwbgLmNj4qQJF1749108676.mp3", "video": ""}, {"text": "A 35-year-old female presents with symptoms of fatigue, pallor, and shortness of breath. Laboratory tests reveal a haemoglobin level of 9 g/dL and microcytic hypochromic red blood cells, consistent with iron deficiency anemia. She is prescribed oral ferrous sulfate. What is the earliest sign that indicates a positive response to iron therapy?", "options": [{"label": "A", "text": "An increase in serum ferritin levels", "correct": false}, {"label": "B", "text": "A rise in haemoglobin levels", "correct": false}, {"label": "C", "text": "An increase in reticulocyte count", "correct": true}, {"label": "D", "text": "Improvement in symptoms of fatigue", "correct": false}], "correct_answer": "C. An increase in reticulocyte count", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Oral Iron</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Characteristic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Information</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Factors Increasing Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Best in <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> environment, take on empty stomach</li>\n<li>Taking iron with vitamin C increases absorption</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Factors Decreasing Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>PPIs and antacids lowers absorption</li>\n<li>Tetracycline binds to iron, reducing absorption</li>\n<li>Food, tea, coffee contain phytates and tannins that decrease iron absorption</li>\n<li>Calcium reduces iron <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> by forming <span class=\"customMeta\" data-dictid=\"5d21b8a47c16927771906f7f0e2590\">insoluble</span> complexes with non-heme iron in the intestine,</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Nausea, vomiting, diarrhea, constipation</li>\n<li>Black stools and tongue indicate regular iron intake</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Indications for <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">Parenteral</span> Iron</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Severe GI <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> or poor compliance: Start <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> iron</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Iron Content of Preparations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li><strong>Ferrous sulfate</strong> (most common, DOC for iron <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> anemia): 32% iron.</li>\n<li><strong>Ferrous gluconate</strong>: 12% iron.</li>\n<li><strong>Ferrous fumarate</strong> (maximum iron content): 33% iron.</li>\n<li><strong>Ferrous <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">sulfate</span> hydrate</strong>: 20% iron.</li>\n<li><strong>Ferrous ascorbate</strong> - new preparation containing Vitamin C (↑ iron absorption)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Earliest Response to Therapy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Increase in <span class=\"customMeta\" data-dictid=\"249592767b16927771976df58de24d\">reticulocyte</span> count: Earliest response to iron therapy</li>\n<li>Hemoglobin levels increase by 0.5-1% per week in <span class=\"customMeta\" data-dictid=\"d09dc1da551692777192706b7f882e\">microcytic</span> anemia</li>\n<li>Oral and <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> iron equally effective for treating iron <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> anemia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Ne7LGR1tIHjLYIHLcQuL1749108797.mp3", "video": ""}, {"text": "Match the diseases with their respective chelator of choice for treatment: Poisoning Chelators 1. Bismuth poisoning A. BAL (Dimercaprol) 2. Copper poisoning B. Penicillamine 3. Iron poisoning in thalassemia C. Calcium Disodium EDTA 4. Cadmium poisoning D. Deferoxamine 5. Acute iron poisoning E. Deferiprone", "options": [{"label": "A", "text": "1-A, 2-B, 3-E, 4-C, 5-D", "correct": true}, {"label": "B", "text": "1-D, 2-C, 3-E, 4-B, 5-A", "correct": false}, {"label": "C", "text": "1-B, 2-D, 3-E, 4-A, 5-C", "correct": false}, {"label": "D", "text": "1-A, 2-C, 3-E, 4-D, 5-B", "correct": false}], "correct_answer": "A. 1-A, 2-B, 3-E, 4-C, 5-D", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:732px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Chelator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Other Information</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dimercaprol (BAL)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Arsenic poisoning</li>\n<li>Mercury poisoning</li>\n<li>Gold poisoning</li>\n<li>Bismuth poisoning</li>\n<li>Nickel poisoning</li>\n<li>Antimony poisoning</li>\n<li>Lead <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> (as <span class=\"customMeta\" data-dictid=\"1a38e9a3321692777180b2468ff799\">adjuvant</span> to <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> <span class=\"customMeta\" data-dictid=\"c4be0f188216927771868a0e7cbe2b\">Disodium</span> EDTA)</li>\n<li>Wilson's disease (as <span class=\"customMeta\" data-dictid=\"1a38e9a3321692777180b2468ff799\">adjuvant</span> to Penicillamine)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C/I in iron and <span class=\"customMeta\" data-dictid=\"0d87690f321692777183bd9aced605\">cadmium</span> <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> because the complexes are toxic.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Calcium <span class=\"customMeta\" data-dictid=\"c4be0f188216927771868a0e7cbe2b\">Disodium</span> EDTA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lead poisoning</li>\n<li>Zinc poisoning</li>\n<li>Copper poisoning</li>\n<li>Manganese poisoning</li>\n<li>Cadmium poisoning</li>\n<li>Radioactive metal poisoning</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>DOC for Manganese, lead, <span class=\"customMeta\" data-dictid=\"0d87690f321692777183bd9aced605\">Cadmium</span> poisoning</li>\n<li>Not effective in <span class=\"customMeta\" data-dictid=\"b59bbde2f816927771924bb2b17b64\">mercury</span> <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> due to mercury's tight binding and <span class=\"customMeta\" data-dictid=\"e485bb67f81692777191dfee6366cc\">localization</span> in deep tissues (inaccessible)</li>\n<li>Doesn't enter brain or CSF, removes toxic metals from accessible sites only.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Penicillamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Wilson's disease</li>\n<li>Copper poisoning</li>\n<li>Mercury poisoning</li>\n<li>Lead <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> (as <span class=\"customMeta\" data-dictid=\"1a38e9a3321692777180b2468ff799\">adjuvant</span> to <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> <span class=\"customMeta\" data-dictid=\"c4be0f188216927771868a0e7cbe2b\">Disodium</span> EDTA)</li>\n<li>Cystinuria and <span class=\"customMeta\" data-dictid=\"c65131cb591692777185e8b4d0055f\">cystine</span> stones</li>\n<li>Scleroderma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>DOC for <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> poisoning</li>\n<li>Alternative drug to dimercaprol/succimer for <span class=\"customMeta\" data-dictid=\"b59bbde2f816927771924bb2b17b64\">mercury</span> poisoning.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Desferoxamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute iron poisoning</li>\n<li>Transfusion siderosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Given parenterally.</li>\n<li>Not preferred in chronic <span class=\"customMeta\" data-dictid=\"64bbd63a0c1692777190f0c8e06e91\">iron overload</span> (Deferiprone is preferred)</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Deferiprone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Iron poisoning</li>\n<li>Transfusion <span class=\"customMeta\" data-dictid=\"e4d583e26b1692777198454df4b41d\">siderosis</span> in <span class=\"customMeta\" data-dictid=\"baed0c93841692777200be26c8b9d2\">thalassemia</span> patients</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Oral drug.</li>\n<li>Less effective than <span class=\"customMeta\" data-dictid=\"423bba3d10169277718536aa18aea0\">deferoxamine</span> for <span class=\"customMeta\" data-dictid=\"64bbd63a0c1692777190f0c8e06e91\">iron overload</span> due to repeated blood transfusion.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dimercaptosuccinic acid (Succimer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Arsenic poisoning</li>\n<li>Mercury poisoning</li>\n<li>Lead poisoning</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May <span class=\"customMeta\" data-dictid=\"c48d8e1e191692777184c994c083c2\">chelate</span> some essential metals like <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> and zinc.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vB88iswi3iJ96PWzsnwM1749109071.mp3", "video": ""}, {"text": "Which of the following does not reduce oral iron absorption?", "options": [{"label": "A", "text": "Tea", "correct": false}, {"label": "B", "text": "Coffee", "correct": false}, {"label": "C", "text": "Pantoprazole", "correct": false}, {"label": "D", "text": "Amla", "correct": true}], "correct_answer": "D. Amla", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:634px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Factors Increasing Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>Best in <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> environment, take on empty stomach</li>\n<li>Taking iron with <span class=\"customMeta\" data-dictid=\"964b8993a1169277720279c9c96cd1\">vitamin C</span> increases absorption</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Factors Decreasing Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<ul>\n<li>PPIs and antacids lowers absorption</li>\n<li>Tetracycline binds to iron, reducing absorption</li>\n<li>Food, tea, coffee contain phytates and tannins that decrease iron absorption</li>\n<li>Calcium reduces iron <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> by forming <span class=\"customMeta\" data-dictid=\"5d21b8a47c16927771906f7f0e2590\">insoluble</span> complexes with non-heme iron in the intestine,</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/84ez79P6kG1C3C2WbWn21749109166.mp3", "video": ""}, {"text": "Which of the following statements on thrombolytics is false?", "options": [{"label": "A", "text": "Activates plasminogen to plasmin", "correct": false}, {"label": "B", "text": "Acts via tissue plasminogen activator", "correct": false}, {"label": "C", "text": "Contraindicated in pregnancy", "correct": false}, {"label": "D", "text": "Can be used in NSTEMI", "correct": true}], "correct_answer": "D. Can be used in NSTEMI", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:800px\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activate <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> to <span class=\"customMeta\" data-dictid=\"7e525df4331692777195cc62f0899a\">plasmin</span> via tissue <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> <span class=\"customMeta\" data-dictid=\"a095f733351692777180a29940c98a\">activator</span> (t-PA)→ digests <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> →lyse <span class=\"customMeta\" data-dictid=\"fc23eb4c0a16927772003dff4101cd\">thrombi</span> to recanalize occluded blood vessels, primarily <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> arteries</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Streptokinase (not in use)</li>\n<li>Urokinase (not in use)</li>\n<li>Alteplase</li>\n<li>Reteplase</li>\n<li>Tenecteplase</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">Infarction</span> (STEMI)\n\t\t\t\t<ul>\n<li>The chief indication is for STEMI.</li>\n<li>Not indicated for unstable <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> (UA) and low-risk NSTEMI.</li>\n<li>Alternative to emergency PCI.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Deep <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">Thrombosis</span> (DVT)</li>\n</ul>\n<ul>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"1c07a1135f1692777187f547678386\">Embolism</span> (PE)\n\t\t\t\t<ul>\n<li>Indicated for large, life-threatening PE</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Peripheral Arterial Occlusion\n\t\t\t\t<ul>\n<li>Indicated when <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> <span class=\"customMeta\" data-dictid=\"b5771b30e816927772007c88fd4e29\">thrombectomy</span> is not possible.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Stroke (Ischemic Stroke)\n\t\t\t\t<ul>\n<li>Alteplase is approved</li>\n<li>Contraindicated after 4.5 hours of symptom onset due to increased <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> risk.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>History of <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> hemorrhage.</li>\n<li>History of <span class=\"customMeta\" data-dictid=\"bef027ba821692777190cb424e9554\">ischemic stroke</span> in the past 3 months.</li>\n<li>History of head injury in the past 3 months.</li>\n<li>Intracranial tumor/vascular abnormality/aneurysms.</li>\n<li>Active bleeding/bleeding disorders.</li>\n<li>Patients on anticoagulants.</li>\n<li>Peptic ulcer, <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> varices.</li>\n<li>Recent wound, fracture, or tooth extraction.</li>\n<li>Major surgery within the past 3 weeks.</li>\n<li>Uncontrolled hypertension.</li>\n<li>Pregnancy.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding Epsilon Amino-Caproic Acid (EACA) is true?", "options": [{"label": "A", "text": "It is an antidote for fibrinolytic agents", "correct": true}, {"label": "B", "text": "Promotes clot dissolution", "correct": false}, {"label": "C", "text": "Activates plasminogen", "correct": false}, {"label": "D", "text": "It is an example of a thrombolytic agent", "correct": false}], "correct_answer": "A. It is an antidote for fibrinolytic agents", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:800px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> <strong>(Option C)</strong>→plasmin not synthesized→fibrin not lysed→prevents <span class=\"customMeta\" data-dictid=\"5e0b40993316927771844dbf382689\">clot</span> <span class=\"customMeta\" data-dictid=\"1924dd4c6e169277718654d32a636f\">dissolution</span> <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples and its uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epsilon Amino-Caproic Acid (EACA)\n\t\t\t\t<ul>\n<li>Antidote for <span class=\"customMeta\" data-dictid=\"f43fcbd30c1692777202bae15ef702\">fibrinolytic</span> agents</li>\n<li>Hyperplasminaemic states with excessive fibrinolysis</li>\n<li>Adjunctive in hemophiliacs for <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> control (e.g., tooth extraction, prostatectomy, trauma)</li>\n</ul>\n</li>\n<li>Tranexamic Acid\n\t\t\t\t<ul>\n<li>Prevention/control of <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> due to <span class=\"customMeta\" data-dictid=\"f43fcbd30c1692777202bae15ef702\">fibrinolytic</span> drugs</li>\n<li>Cardiopulmonary <span class=\"customMeta\" data-dictid=\"4fc6b3ee501692777183061d4f55ff\">bypass</span> surgery</li>\n<li>Tonsillectomy, prostatic surgery, tooth <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">extraction</span> in hemophiliacs</li>\n<li>Menorrhagia, <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> epistaxis, <span class=\"customMeta\" data-dictid=\"e53fabffaa16927771897154b79eed\">hyphema</span> due to <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> trauma, <span class=\"customMeta\" data-dictid=\"f6768ff15f1692777195a493cad3a9\">peptic</span> ulcer</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 19 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 72-year-old woman with a history of atrial fibrillation and a recent deep vein thrombosis (DVT) is admitted to the hospital. The physician decides to initiate anticoagulation therapy with warfarin to prevent further thromboembolic complications. Which of the following best describes the mechanism of action of warfarin?", "options": [{"label": "A", "text": "Inhibits the synthesis of fibrin", "correct": false}, {"label": "B", "text": "Inhibits platelet aggregation", "correct": false}, {"label": "C", "text": "Inhibits the synthesis of vitamin K-dependent clotting factors", "correct": true}, {"label": "D", "text": "Directly binds to and inactivates thrombin", "correct": false}], "correct_answer": "C. Inhibits the synthesis of vitamin K-dependent clotting factors", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/sshiDVGyr7uvGjHRg8mw1734419715.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 58-year-old woman with a history of mitral valve replacement (on warfarin) and trigeminal neuralgia (on carbamazepine) has been prescribed clarithromycin for a chest infection. Her regular medications include amlodipine and atorvastatin. Her INR is 1.3 (target &amp;gt; 3 for mechanical heart valve). Which drug most likely interacted with warfarin to give this INR?", "options": [{"label": "A", "text": "Amlodipine", "correct": false}, {"label": "B", "text": "Atorvastatin", "correct": false}, {"label": "C", "text": "Clarithromycin", "correct": false}, {"label": "D", "text": "Carbamazepine", "correct": true}], "correct_answer": "D. Carbamazepine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:596px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on Warfarin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbamazepine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ INR (↓ <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> effect)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP inducer</strong> → ↑ <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> metabolism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clarithromycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↑ INR (↑ <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> effect)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP inhibitor</strong> → ↓ <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> metabolism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amlodipine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No significant effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No major CYP interaction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Atorvastatin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild unpredictable changes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competes with <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> at CYP enzymes</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:424px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Kinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zero-order kinetics</strong> at high doses</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excretion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Excreted in bile</strong>, <strong>safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protein Binding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>99% <span class=\"customMeta\" data-dictid=\"d82fcb9d1f16927771836a9f6ccf14\">bound</span> to albumin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dialysis Removal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Not dialyzable</strong> due to high protein binding</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:186px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sodium Valproate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Isoniazid</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cimetidine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ketoconazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluconazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcohol (binge)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chloramphenicol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Erythromycin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sulfonamides</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ciprofloxacin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Omeprazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metronidazole</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:189px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbamazepine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcohol (chronic)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phenytoin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Griseofulvin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phenobarbital</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sulphonylureas</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ApAr7EIPsMZeK4ccWBO81747763993.mp3", "video": ""}, {"text": "An 82-year-old man presents to the emergency department with a sudden onset of severe headache and altered mental status. His CT Scan reveals an intracranial haemorrhage. He has a history of atrial fibrillation and has been taking warfarin. His INR is 5.8. Which of the following is the most appropriate treatment?", "options": [{"label": "A", "text": "Fresh Frozen Plasma", "correct": false}, {"label": "B", "text": "Tranexamic acid", "correct": false}, {"label": "C", "text": "Vitamin K", "correct": false}, {"label": "D", "text": "Prothrombin complex concentrate", "correct": true}], "correct_answer": "D. Prothrombin complex concentrate", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Major bleeding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Stop warfarin.</li>\n<li>Administer <span class=\"customMeta\" data-dictid=\"94b02f097916927771962072dbeeac\">prothrombin</span> complex concentrate.</li>\n<li>Administer <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> vitamin K1.</li>\n<li>If <span class=\"customMeta\" data-dictid=\"94b02f097916927771962072dbeeac\">prothrombin</span> complex concentrate is not available, give fresh frozen plasma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>INR &gt; 8 with minor or no bleeding</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Stop warfarin.</li>\n<li>Administer <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> or oral vitamin K1.</li>\n<li>Restart <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> when INR is &lt; 5.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>INR 5 - 8 with minor bleeding</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>INR 5 - 8 with no bleeding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Stop warfarin.</li>\n<li>Restart <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> when INR is &lt; 5.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>INR above target range but &lt; 5</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reduce or omit one or two doses of warfarin</li>\n<li>Measure INR in 2-3 days</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old patient is being evaluated for the initiation of warfarin therapy for various indications. Which of the following indications for warfarin therapy requires the highest target INR range?", "options": [{"label": "A", "text": "Atrial fibrillation (non-valvular)", "correct": false}, {"label": "B", "text": "Deep vein thrombosis (DVT) prophylaxis", "correct": false}, {"label": "C", "text": "Mechanical heart valve replacement", "correct": true}, {"label": "D", "text": "Myocardial infarction (MI) prevention", "correct": false}], "correct_answer": "C. Mechanical heart valve replacement", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Target INR Range</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atrial Fibrillation</p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>2.0 - 2.5</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Venous <span class=\"customMeta\" data-dictid=\"237b2a1dfa1692777200a074fd1072\">Thromboembolism</span> (VTE) Prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bioprosthetic <span class=\"customMeta\" data-dictid=\"1a060c24961692777189bcbbf1d2cd\">Heart Valves</span> (first 3 months)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Post-Myocardial Infarction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment of DCT, PE, TIA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2.5 - 3.0</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanical <span class=\"customMeta\" data-dictid=\"c936e2cd131692777196b1d877f678\">Prosthetic</span> Heart Valves</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>3.0 - 3.5</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recurrent Thromboembolism</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old man has been taking Warfarin 7mg daily for the treatment of left arm DVT for the past 2 years. He also takes furosemide 40mg for HTN. He is usually compliant with his medications. What is the most important adverse effect the patient should be careful with?", "options": [{"label": "A", "text": "Peripheral Neuropathy", "correct": false}, {"label": "B", "text": "Phototoxicity", "correct": false}, {"label": "C", "text": "Headache", "correct": true}, {"label": "D", "text": "Constipation", "correct": false}], "correct_answer": "C. Headache", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which oral anticoagulant is known for inhibiting activated Factor Xa and is used for prophylaxis and treatment of deep vein thrombosis (DVT)?", "options": [{"label": "A", "text": "Warfarin", "correct": false}, {"label": "B", "text": "Dabigatran", "correct": false}, {"label": "C", "text": "Apixaban", "correct": true}, {"label": "D", "text": "Ethylbiscoumacetate", "correct": false}], "correct_answer": "C. Apixaban", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct Factor Xa Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">Thrombin</span> Inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit Factor Xa directly</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> (Factor IIa) directly</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Apixaban, Rivaroxaban, Edoxaban, Betrixaban</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dabigatran, Ximelagatran</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prophylaxis of <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"237b2a1dfa1692777200a074fd1072\">thromboembolism</span> following knee or hip replacement surgery.</li>\n<li>Prophylaxis of stroke in patients with atrial fibrillation.</li>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"712bb2d2b716927771867d5505033c\">deep <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> thrombosis</span> and <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> embolism.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advantages of novel anticoagulants over warfarin</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rapid onset and offset of action.</li>\n<li><strong>No need for routine laboratory monitoring.</strong></li>\n<li><strong>Lower risk of bleeding.</strong></li>\n<li>Fewer drug interactions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/y0Ytq664Fq7GlkVixGVy1746257009.mp3", "video": ""}, {"text": "Which form of Vitamin K is used as an antidote for coumarin anticoagulant overdose, such as warfarin?", "options": [{"label": "A", "text": "Vitamin K1", "correct": true}, {"label": "B", "text": "Vitamin K2", "correct": false}, {"label": "C", "text": "Vitamin K3", "correct": false}, {"label": "D", "text": "Vitamin K4", "correct": false}], "correct_answer": "A. Vitamin K1", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Forms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitamin K1 (Phytonadione)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antidote for <span class=\"customMeta\" data-dictid=\"1b5b80bf9d1692777185ac41aa7964\">coumarin</span> <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> <span class=\"customMeta\" data-dictid=\"3f4eecb1c6169277719459c801fb19\">overdose</span> (e.g., warfarin).</li>\n<li>Prophylaxis and treatment of <span class=\"customMeta\" data-dictid=\"71c2092f15169277720243eb1590b0\">Vitamin K</span> <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> bleeding.</li>\n<li>Newborns to prevent hemorrhagic disease of the newborn.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"245b6a0cc91692777181d63c66b3a3\">anaphylactoid</span> reactions on IV injection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitamin K2 (Menaquinone)</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bone <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> regulation in bones and arteries.</li>\n<li>Used in osteoporosis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generally considered safe. Very few reported adverse effects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitamin K3 (Menadione)</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not commonly used for <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> reversal.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hemolysis (especially in <span class=\"customMeta\" data-dictid=\"96985248371692777188cfb38ca861\">G6PD</span> deficiency).</li>\n<li>Risk of <span class=\"customMeta\" data-dictid=\"34fea2624516927771905a0047f439\">kernicterus</span> in newborns.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4lEj3cQC82hRomqKMUAc1749063207.mp3", "video": ""}, {"text": "Which drugs exert their anticoagulant effect primarily by binding to antithrombin III (AT-III) to inhibit factor Xa selectively?", "options": [{"label": "A", "text": "Lepirudin", "correct": false}, {"label": "B", "text": "Dabigatran", "correct": false}, {"label": "C", "text": "Fondaparinux", "correct": true}, {"label": "D", "text": "Heparin", "correct": false}], "correct_answer": "C. Fondaparinux", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">Thrombin</span> Inhibitors</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> (factor IIa) directly without cofactors.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hirudin derivatives: </strong>Hirudin, Lepirudin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-hirudin (Synthetic):</strong> Argatroban, Bivalirudin.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">Thrombin</span> Inhibitors</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enhance <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III activity to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> indirectly.</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unfractionated Heparin:</strong> Heparin</p>\n<ul>\n<li>Long chain of molecule bind to both factor 2 and 10 </li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Low Molecular Weight Heparin (LMWH):</strong> Enoxaparin, Dalteparin, Tinzaparin</p>\n<ul>\n<li>Long chain of molecule binds to factor 10 &gt; 2</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultra Low Molecular Weight Heparin (ULMWH):</strong> Fondaparinux, Idraparinux, Danaparoid (not commonly used)</p>\n<ul>\n<li>Long chain of molecule bind selectively to factor 2</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Synthetic Direct Factor Xa Inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bind directly to factor Xa to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> its activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fondaparinux, Idraparinux</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JzXzAMJBZZonUThe2Joe1748863553.mp3", "video": ""}, {"text": "Which of the following statements is not true regarding the features of various types of heparin?", "options": [{"label": "A", "text": "ULMW heparin has the shortest half-life.", "correct": true}, {"label": "B", "text": "LMW heparin is primarily excreted through urine.", "correct": false}, {"label": "C", "text": "HMW heparin requires monitoring of aPTT.", "correct": false}, {"label": "D", "text": "Fondaparinux is a synthetic pentasaccharide heparin", "correct": false}], "correct_answer": "A. ULMW heparin has the shortest half-life.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:621px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Heparin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">Molecular Weight</span> (HMW)</strong></p>\n<p>Heparin (unfractionated)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III, inhibits <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> and factor Xa.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Derived from <span class=\"customMeta\" data-dictid=\"0c347e4ef21692777196791908099f\">porcine</span> <span class=\"customMeta\" data-dictid=\"7840cca3ed16927771901d2f6cb32b\">intestine</span> or <span class=\"customMeta\" data-dictid=\"6c086f82651692777183dedda5f99a\">bovine</span> lung.</li>\n<li>Requires monitoring of <span class=\"customMeta\" data-dictid=\"c91819a65716927771810b66ea6869\">aPTT</span> Shorter half-life.</li>\n<li>Safe in renal failure</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Low Molecular Weight</strong></p>\n<p><strong>(LMW)</strong></p>\n<p>Enoxaparin, Dalteparin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preferentially inhibits factor Xa.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Derived from LMW fragments of unfractionated heparin.</li>\n<li>Primarily <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> excretion</li>\n<li>Monitoring of anti-factor Xa levels.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ultra Low Molecular Weight</strong></p>\n<p><strong>(ULMW)</strong></p>\n<p>Fondaparinux</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selectively inhibits factor Xa.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Synthetic pentasaccharide</li>\n<li>Longer half-life.</li>\n<li>No routine monitoring is needed for <span class=\"customMeta\" data-dictid=\"42f1e4deb8169277718412c0681a54\">coagulation</span> parameters.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/SqNloDnSUe2rLc3Uwwt61749063510.mp3", "video": ""}, {"text": "A 65-year-old man who was admitted to the ICU due to septicemia started showing features of disseminated intravascular coagulation. He was then started on a parenteral anticoagulant injection. Which of the following anticoagulants was most probably used in this patient?", "options": [{"label": "A", "text": "Fondaparinux", "correct": false}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Unfractionated heparin", "correct": true}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "C. Unfractionated heparin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindication </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>HMWH</strong></p>\n<p>Unfractionated heparin</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disseminated <span class=\"customMeta\" data-dictid=\"837d6227d81692777190a063ea2cd4\">intravascular</span> coagulation</li>\n<li>Hemodialysis</li>\n<li>Atrial fibrillation</li>\n<li>Maintain <span class=\"customMeta\" data-dictid=\"8c660f0c321692777194046901e354\">patency</span> of cannulae and shunts.</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Any major bleed</li>\n<li>Thrombocytopenia</li>\n<li>Heparin-induced thrombocytopenia</li>\n<li>Cerebrovascular accident</li>\n<li>Aneurysm</li>\n<li>Recent <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> surgery or <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> surgery</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> (except for unfractionated heparin)</li>\n<li>GIT ulcer</li>\n<li>Hemophilia</li>\n<li>Severe uncontrolled hypertension</li>\n<li>Bacterial endocarditis</li>\n<li>Hypersensitivity to heparin</li>\n<li>Large malignancies</li>\n<li>Liver cirrhosis</li>\n<li>Tuberculosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>LMWH</strong></p>\n<p>Dalteparin</p>\n<p>Enoxaparin <strong>(Option B)</strong></p>\n<p>Tinzaparin</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prophylaxis of <span class=\"customMeta\" data-dictid=\"712bb2d2b716927771867d5505033c\">Deep <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> thrombosis</span> &amp; <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> embolism</li>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> syndrome &amp; Antiphospholipid syndrome.</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ULMWH </strong></p>\n<p>Fondaparinux <strong>(Option A)</strong></p>\n<p>Idraparinux</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 48-year-old man who was recently diagnosed with unstable angina was started on heparin. After 2 days, he developed ‘Heparin-induced thrombocytopenia’. Which of the following types of heparin is not associated with HIT?", "options": [{"label": "A", "text": "Unfractionated heparin", "correct": false}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Dalteparin", "correct": false}, {"label": "D", "text": "Fondaparinux", "correct": true}], "correct_answer": "D. Fondaparinux", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/IXfxa2lojR6MINJqqs2T1734419478.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anticoagulant is preferred for treating patients with heparin-induced thrombocytopenia (HIT) due to its specific indication, effectiveness in avoiding cross-reactivity with heparin antibodies, and safety profile?", "options": [{"label": "A", "text": "Warfarin", "correct": false}, {"label": "B", "text": "Fondaparinux", "correct": false}, {"label": "C", "text": "Argatroban", "correct": true}, {"label": "D", "text": "Enoxaparin", "correct": false}], "correct_answer": "C. Argatroban", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:591px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Argatroban</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action (MOA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> that binds reversibly to the <span class=\"customMeta\" data-dictid=\"fd8ccc41d916927771839aa8da6767\">catalytic</span> site of thrombin, inhibiting its activity.</li>\n<li>It prevents thrombin-mediated conversion of <span class=\"customMeta\" data-dictid=\"a137b7092a16927772025412d4ef05\">fibrinogen</span> to <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> and inhibits <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> and aggregation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bleeding (ranging from minor to severe haemorrhage).</li>\n<li>Hypersensitivity reactions.</li>\n<li>Elevated liver enzymes.</li>\n<li>Local <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> at the <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> site.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prophylaxis and treatment of <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> in patients at risk of HIT.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Active major bleeding</li>\n<li>Hypersensitivity to Argatroban.</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> impairment.</li>\n<li>Concomitant use with strong CYP3A4 inhibitors.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old pregnant female who is in her first trimester was diagnosed with antiphospholipid syndrome. As a prophylaxis for thrombosis and risk of miscarriage, anticoagulant therapy was started. Which of the following anticoagulant agents is unsafe to use during the first trimester of pregnancy?", "options": [{"label": "A", "text": "Fondaparinux", "correct": false}, {"label": "B", "text": "Warfarin", "correct": true}, {"label": "C", "text": "Dalteparin", "correct": false}, {"label": "D", "text": "Unfractionated heparin", "correct": false}], "correct_answer": "B. Warfarin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8P7w18qe8H8kPtfcV3dz1734419179.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:690px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational period </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants preferred </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0-12 weeks </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>LMW/ULMW heparin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>12-36 weeks</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>LMW/ULMW heparin</li>\n<li>As <span class=\"customMeta\" data-dictid=\"9bd7909f881692777194ca6ea37a0c\">organogenesis</span> is completed, <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">Warfarin</span> may be used only in cases of patients with mechanical <span class=\"customMeta\" data-dictid=\"c936e2cd131692777196b1d877f678\">prosthetic</span> valves</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>36 weeks till delivery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>LMW/ULMW heparin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>During delivery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> is used due to the risk of <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>During <span class=\"customMeta\" data-dictid=\"4abd8094e51692777191b1eb073735\">lactation</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Warfarin is preferred over heparin</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants safe in pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants contraindicated in pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Heparin (unfractionated and low <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparin)</li>\n<li>Fondaparinux</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Warfarin</li>\n<li>Direct Oral Anticoagulants dabigatran, rivaroxaban, apixaban, and edoxaban</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 78-year-old male patient presents to the emergency department with features of acute deep vein thrombosis. The patient has a history of atrial fibrillation and chronic kidney disease. He is currently on anticoagulant therapy. Which set of anticoagulants is safe to use in this patient?", "options": [{"label": "A", "text": "Warfarin and Fondaparinux", "correct": false}, {"label": "B", "text": "Warfarin and unfractionated heparin", "correct": true}, {"label": "C", "text": "Unfractionated heparin and Dabigatran", "correct": false}, {"label": "D", "text": "Rivaroxaban and Fondaparinux", "correct": false}], "correct_answer": "B. Warfarin and unfractionated heparin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:651px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Excretion </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Safety in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> disease </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Warfarin</strong></p>\n<p>(Vitamin K antagonist)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hepatic excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unfractionated heparin</strong></p>\n<p>(High <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reticuloendothelial cells and <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Safe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fondaparinux</strong></p>\n<p>(Ultra-low <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unsafe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dabigatran</strong></p>\n<p>(Direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> inhibitor)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unsafe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rivaroxaban</strong></p>\n<p>(Direct factor Xa inhibitor)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal and <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> excretion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unsafe</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following anticoagulants with their antidotes. Anticoagulants Antidote 1. Warfarin A. Protamine Sulfate 2. Heparin B. Andexanet Alfa 3. Dabigatran C. Vitamin K 4. Apixaban D. Idarucizumab", "options": [{"label": "A", "text": "1-B, 2-C, 3-A, 4-D", "correct": false}, {"label": "B", "text": "1-C, 2-A, 3-D, 4-B", "correct": true}, {"label": "C", "text": "1-C, 2-D, 3-B, 4-A", "correct": false}, {"label": "D", "text": "1-B, 2-A, 3-C, 4-D", "correct": false}], "correct_answer": "B. 1-C, 2-A, 3-D, 4-B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:669px\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Anticoagulant </strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Antidote </strong></p>\n</th>\n<th scope=\"col\" style=\"vertical-align:top\">\n<p><strong>Mechanism </strong></p>\n</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Warfarin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitamin K</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitamin K helps reverse the warfarin-induced <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of Vitamin K <span class=\"customMeta\" data-dictid=\"29ca44bd601692777187c3d92d645b\">epoxide</span> reductase, resulting in ↑ <span class=\"customMeta\" data-dictid=\"932c90683216927771833ff878c33a\">carboxylation</span> and <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors II, VII, IX, and X.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Heparin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Protamine Sulfate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It neutralises and prevents the binding of <span class=\"customMeta\" data-dictid=\"050e27829716927771885eddb2620c\">heparin</span> and <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dabigatran </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Idarucizumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is a <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> that binds to dabigatran and neutralises its <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Apixaban </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Andexanet Alfa</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It acts as a decoy <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> for apixaban, binds to apixaban, and reverses its <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> effects.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A first-trimester pregnant female has DVT and needs anticoagulation. Which of the following anticoagulants is preferred?", "options": [{"label": "A", "text": "Enoxaparin", "correct": false}, {"label": "B", "text": "Clopidogrel", "correct": true}, {"label": "C", "text": "Betrixaban", "correct": false}, {"label": "D", "text": "Warfarin", "correct": false}], "correct_answer": "B. Clopidogrel", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Anticoagulants in pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gestational period </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants preferred </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0-12 weeks </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>LMW/ULMW heparin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>12-36 weeks</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>LMW/ULMW heparin</li>\n<li>As <span class=\"customMeta\" data-dictid=\"9bd7909f881692777194ca6ea37a0c\">organogenesis</span> is completed, <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">Warfarin</span> may be used only in cases of patients with mechanical <span class=\"customMeta\" data-dictid=\"c936e2cd131692777196b1d877f678\">prosthetic</span> valves</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>36 weeks till delivery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>LMW/ULMW heparin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>During delivery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> is used due to the risk of <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> hemorrhage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>During <span class=\"customMeta\" data-dictid=\"4abd8094e51692777191b1eb073735\">lactation</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Warfarin is preferred over heparin</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants safe in pregnancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anticoagulants contraindicated in pregnancy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Heparin (unfractionated and low <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparin)</li>\n<li>Fondaparinux</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Warfarin</li>\n<li>Direct Oral Anticoagulants dabigatran, rivaroxaban, apixaban, and edoxaban</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "At what point should we transition a pregnant woman with a prosthetic valve and rheumatic heart disease from warfarin to heparin?", "options": [{"label": "A", "text": "32 weeks", "correct": false}, {"label": "B", "text": "36 weeks", "correct": false}, {"label": "C", "text": "37 weeks", "correct": true}, {"label": "D", "text": "40 weeks", "correct": false}], "correct_answer": "C. 37 weeks", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the statements below correctly describes pegylated filgrastim?", "options": [{"label": "A", "text": "Duration of action is shorter than normal filgrastim", "correct": false}, {"label": "B", "text": "Added advantage is that it can be taken orally", "correct": false}, {"label": "C", "text": "It should not be administered in sickle cell patients", "correct": true}, {"label": "D", "text": "It is not effective in the treatment of severe neutropenia", "correct": false}], "correct_answer": "C. It should not be administered in sickle cell patients", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C: Pegylated-filgrastim should not be administered in sickle cell patients.\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child accidentally took a bottle full of iron tablets. Which of the drugs is used as an antidote for iron poisoning?", "options": [{"label": "A", "text": "Luspatercept", "correct": false}, {"label": "B", "text": "Deferoxamine", "correct": true}, {"label": "C", "text": "Deferiprone", "correct": false}, {"label": "D", "text": "DMSA", "correct": false}], "correct_answer": "B. Deferoxamine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Deferoxamine&lt;br/&gt;\n&lt;br/&gt;\nE\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Chelator</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Other Information</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Deferoxamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Acute iron poisoning</li>\n<li>Transfusion siderosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Given parenterally.</li>\n<li>Not preferred in chronic <span class=\"customMeta\" data-dictid=\"64bbd63a0c1692777190f0c8e06e91\">iron overload</span> (Deferiprone is preferred)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Deferiprone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Iron poisoning</li>\n<li>Transfusion <span class=\"customMeta\" data-dictid=\"e4d583e26b1692777198454df4b41d\">siderosis</span> in <span class=\"customMeta\" data-dictid=\"baed0c93841692777200be26c8b9d2\">thalassemia</span> patients</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Oral drug.</li>\n<li>Less effective than <span class=\"customMeta\" data-dictid=\"423bba3d10169277718536aa18aea0\">deferoxamine</span> for <span class=\"customMeta\" data-dictid=\"64bbd63a0c1692777190f0c8e06e91\">iron overload</span> due to repeated blood transfusion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dimercaptosuccinic acid (Succimer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Arsenic poisoning</li>\n<li>Mercury poisoning</li>\n<li>Lead poisoning</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It may <span class=\"customMeta\" data-dictid=\"c48d8e1e191692777184c994c083c2\">chelate</span> some essential metals like <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> and zinc.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on anti-cancer therapy developed an infection. Blood analysis revealed a total leucocyte count of 2000/mm3. Which of the following drugs is likely to be effective in this patient?", "options": [{"label": "A", "text": "Romiplostim", "correct": false}, {"label": "B", "text": "Oprelvekin", "correct": false}, {"label": "C", "text": "Filgrastim", "correct": true}, {"label": "D", "text": "Erythropoietin", "correct": false}], "correct_answer": "C. Filgrastim", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Filgrastim</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs promoting WBC formation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>G-CSF</strong></p>\n<p>(Glycoprotein with 175 <span class=\"customMeta\" data-dictid=\"543f207eb51692777181723491a358\">amino</span> acids)</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Stimulates colony-forming unit (CFU) granulocytes to increase <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production.</li>\n<li>Enhances <span class=\"customMeta\" data-dictid=\"b68a8f1b37169277719547f1cfda59\">phagocytic</span> and cytotoxic activities of neutrophils.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Treats severe <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> after <span class=\"customMeta\" data-dictid=\"0a266da66816927771824d58668832\">autologous</span> <span class=\"customMeta\" data-dictid=\"d2e0ab499c169277718886ab5a46bf\">hematopoietic</span> <span class=\"customMeta\" data-dictid=\"467c0b4fc016927771997e1043aeda\">stem cell transplantation</span> and high-dose cancer chemotherapy</li>\n<li>Treats severe <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> neutropenias</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Filgrastim</strong></p>\n<p>(Recombinant human G-CSF)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Same use as G-CSF</li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> in patients with AIDS receiving zidovudine</li>\n<li>Used in patients undergoing <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood stem cell collection for stem cell transplantation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>PEG-Filgrastim</strong></p>\n<p>(Longer acting <span class=\"customMeta\" data-dictid=\"761475dbbd169277719523f180ef28\">pegylated</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of G-CSF)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prevention of chemotherapy-induced neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sargramostim</strong></p>\n<p>(Recombinant human GM-CSF)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates myelopoiesis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Autologous <span class=\"customMeta\" data-dictid=\"c8a8c935a41692777191610f6aacb4\">marrow</span> <span class=\"customMeta\" data-dictid=\"ee9f07b0a81692777200e416e4e5d7\">transplantation</span> treatment</li>\n<li>Mobilizes CD34+ progenitor cells for <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood stem cell collection post-myeloablative chemotherapy</li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> in patients on <span class=\"customMeta\" data-dictid=\"901bf573f216927771905f0abedca2\">intensive</span> cancer chemotherapy</li>\n<li>Supports <span class=\"customMeta\" data-dictid=\"9a34416acd16927771930416df6115\">myelopoiesis</span> in <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> neutropenia, myelodysplasia, <span class=\"customMeta\" data-dictid=\"1ea06afcbd1692777181199bfa3300\">aplastic</span> anemia, and AIDS-associated neutropenia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Molgramostim</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Targets GM-CSF receptors on <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> <span class=\"customMeta\" data-dictid=\"ae13cdc5c3169277719683e9f6bda5\">precursor</span> cells</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increases granulocytes and monocytes</li>\n<li>Approved for chemotherapy-induced neutropenia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not correctly matched?", "options": [{"label": "A", "text": "Andexanet alfa : Edoxaban", "correct": false}, {"label": "B", "text": "Andexanet alfa : Rivaroxaban", "correct": false}, {"label": "C", "text": "Idarucizumab : Dabigatran", "correct": false}, {"label": "D", "text": "Ciraparantag : Fondaparinux", "correct": true}], "correct_answer": "D. Ciraparantag : Fondaparinux", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Ciraparantag: Fondaparinu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a history of ischemic stroke was started on clopidogrel. However, she had another stroke after 6 months. Which of the following could be responsible for the failure of clopidogrel in this patient?", "options": [{"label": "A", "text": "Reduced activity of CYP2C19", "correct": true}, {"label": "B", "text": "Downregulation of CYP2D6", "correct": false}, {"label": "C", "text": "Upregulation of CYP1A1", "correct": false}, {"label": "D", "text": "Downregulation of CYP2E1", "correct": false}], "correct_answer": "A. Reduced activity of CYP2C19", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Clopidogrel</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Clopidogrel is a <span class=\"customMeta\" data-dictid=\"1c0d8a64fa1692777196f90166732c\">prodrug</span> that requires <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> by CYP2C19 to become an active <span class=\"customMeta\" data-dictid=\"257da9409416927771815e64ee5df1\">antiplatelet</span> drug.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Activation </p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>CYP2C19 is an <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> found in the liver and is responsible for converting clopidogrel into its active form.</li>\n<li>Certain genetic polymorphisms or drug interactions can lead to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> activity of CYP2C19, and the <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of clopidogrel may be reduced</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses </p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Post Myocardial infarction</li>\n<li>Post <span class=\"customMeta\" data-dictid=\"75a3b02a801692777184b9cb7f0c0a\">cerebrovascular</span> accidents</li>\n<li>Peripheral arterial diseases</li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> syndrome</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Adverse effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Risk of <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> if used with anticoagulants or antiplatelets</li>\n<li>Rare - thrombotic thrombocytopenic purpura</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table>\n<tbody>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Enzyme</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Substrate</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>CYP2D6</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>SSRIs, Opiates, Beta-blockers, <span class=\"customMeta\" data-dictid=\"66bf14385516927772001b3646b855\">tricyclic</span> antidepressants</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>CYP1A1/2</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Theophylline, Paracetamol, caffeine</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>CYP2E1</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Alcohol, halothane, Paracetamol</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of alteplase, a tissue plasminogen activator (tPA)?", "options": [{"label": "A", "text": "Inhibits Vitamin K-dependent factors", "correct": false}, {"label": "B", "text": "Inhibits factor X", "correct": false}, {"label": "C", "text": "Promotes fibrinolysis", "correct": true}, {"label": "D", "text": "Activation of thrombin", "correct": false}], "correct_answer": "C. Promotes fibrinolysis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Promotes fibrinolysis</p>\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<thead>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Fibrinolytic Drugs (Thrombolytics)</strong></p>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Activate <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> to <span class=\"customMeta\" data-dictid=\"7e525df4331692777195cc62f0899a\">plasmin</span> via tissue <span class=\"customMeta\" data-dictid=\"bab1a0998e1692777195514ec82e5f\">plasminogen</span> <span class=\"customMeta\" data-dictid=\"a095f733351692777180a29940c98a\">activator</span> (t-PA)</strong>→ digests <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> →lyse <span class=\"customMeta\" data-dictid=\"fc23eb4c0a16927772003dff4101cd\">thrombi</span> to recanalize occluded blood vessels, primarily <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> arteries.</p>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examples </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Streptokinase (not in use)</li>\n<li>Urokinase (not in use)</li>\n<li><strong>Alteplase </strong></li>\n<li>Reteplase</li>\n<li>Tenecteplase</li>\n</ul>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Acute Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">Infarction</span> (STEMI)\n\t\t\t\t<ul>\n<li>The chief indication is for STEMI.</li>\n<li>Not indicated for unstable <span class=\"customMeta\" data-dictid=\"030cd51b341692777181d15302c8d4\">angina</span> (UA) and low-risk NSTEMI.</li>\n<li>Alternative to emergency PCI.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Deep <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">Thrombosis</span> (DVT)</li>\n</ul>\n<ul>\n<li>Pulmonary <span class=\"customMeta\" data-dictid=\"1c07a1135f1692777187f547678386\">Embolism</span> (PE)\n\t\t\t\t<ul>\n<li>Indicated for large, life-threatening PE</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Peripheral Arterial Occlusion\n\t\t\t\t<ul>\n<li>Indicated when <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> <span class=\"customMeta\" data-dictid=\"b5771b30e816927772007c88fd4e29\">thrombectomy</span> is not possible.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Stroke (Ischemic Stroke)\n\t\t\t\t<ul>\n<li>Alteplase is approved</li>\n<li>Contraindicated after 4.5 hours of symptom onset due to increased <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> risk.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>History of <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> hemorrhage.</li>\n<li>History of <span class=\"customMeta\" data-dictid=\"bef027ba821692777190cb424e9554\">ischemic stroke</span> in the past 3 months.</li>\n<li>History of head injury in the past 3 months.</li>\n<li>Intracranial tumor/vascular abnormality/aneurysms.</li>\n<li>Active bleeding/bleeding disorders.</li>\n<li>Patients on anticoagulants.</li>\n<li>Peptic ulcer, <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> varices.</li>\n<li>Recent wound, fracture, or tooth extraction.</li>\n<li>Major surgery within the past 3 weeks.</li>\n<li>Uncontrolled hypertension.</li>\n<li><strong>Pregnancy.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young boy with a history of multiple blood transfusions presents with bone pain for the past 6 months. A peripheral smear showed sickle-shaped RBCs. Which of the following drugs are not used in the treatment of his condition?", "options": [{"label": "A", "text": "Bebtelovimab", "correct": true}, {"label": "B", "text": "Voxelotor", "correct": false}, {"label": "C", "text": "Hydroxyurea", "correct": false}, {"label": "D", "text": "L-glutamine", "correct": false}], "correct_answer": "A. Bebtelovimab", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:754px\">\n<tbody>\n<tr>\n<td colspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacological Treatments for sickle cell anemia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hydroxyurea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Voxelotor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Crizanlizumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>L-Glutamine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> (HbF) levels.</li>\n<li>Reduces sickle <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> (HbS) polymerization.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases hemoglobin's <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for oxygen.</li>\n<li>Reduces <span class=\"customMeta\" data-dictid=\"a4f67f90fa169277719829965d14e9\">sickling</span> and hemolysis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks P-selectin to prevent sickle cell-endothelial adhesion.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> stress in sickle erythrocytes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Standard care for all patients with sickle cell <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> and HbS-β0 thalassemia.</li>\n<li>It is used for patients of all ages regardless of the symptoms.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Improves <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> levels in sickle cell disease patients.</li>\n<li>It is added with <span class=\"customMeta\" data-dictid=\"ac923489f3169277718998b7f862df\">hydroxyurea</span> for <span class=\"customMeta\" data-dictid=\"8fabe131a916927771802a448a329c\">additive</span> results especially in adults when the symptoms are not sufficiently <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> by <span class=\"customMeta\" data-dictid=\"ac923489f3169277718998b7f862df\">hydroxyurea</span> alone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reduces frequency of painful crises.</li>\n<li>Can be added with <span class=\"customMeta\" data-dictid=\"ac923489f3169277718998b7f862df\">hydroxyurea</span> and Voxelotor for <span class=\"customMeta\" data-dictid=\"8fabe131a916927771802a448a329c\">additive</span> results when the vaso <span class=\"customMeta\" data-dictid=\"3cd09dcb0e1692777194e41a18d184\">occlusive</span> complications still continue with these medications at the right doses.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Helps manage pain episodes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dosage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Start at ~20 mg/kg for children.</li>\n<li>Titrate to the <span class=\"customMeta\" data-dictid=\"86ef7aab6c1692777191067c2c9040\">maximum tolerated dose</span> based on blood counts.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1500 mg daily.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Administer intravenously once a month.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Specific <span class=\"customMeta\" data-dictid=\"b5bd69c9791692777186a40f45ffb6\">dosage</span> determined in clinical trials.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Important Details</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reduces pain crises and <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> chest syndrome by ~50%.</li>\n<li>Treatment is initiated in the first year of life.</li>\n<li>Long-term use has decreased mortality.</li>\n<li>Increases <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> by about 1 gm/dL.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Associated with a 1 g/dL increase in <span class=\"customMeta\" data-dictid=\"ad2073fe6716927771885f3c1ec652\">hemoglobin</span> in 59% of patients.</li>\n<li>Long-term benefits and safety are under investigation.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Associated with a ~45% reduction in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> painful episodes.</li>\n<li>No significant effect on <span class=\"customMeta\" data-dictid=\"c2b082746716927771888f0933941d\">hemolysis</span> is observed.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shows a 25% reduction in painful episodes.</li>\n<li>Associated with a 33% decrease in hospitalizations compared to placebo.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "G6PD (Glucose 6-phosphate dehydrogenase) can manifest with which of the following drugs?", "options": [{"label": "A", "text": "Primaquine", "correct": true}, {"label": "B", "text": "Mefloquine", "correct": false}, {"label": "C", "text": "Penicillin", "correct": false}, {"label": "D", "text": "Tetracycline", "correct": false}], "correct_answer": "A. Primaquine", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lL2eKF3bSkTdw19XrkXk1745388686.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G6PD deficiency</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is an <strong>X-linked genetic disorder </strong>that impairs <span class=\"customMeta\" data-dictid=\"248111ded81692777197946454db52\">red blood cell</span> protection against <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> stress, leading to <span class=\"customMeta\" data-dictid=\"d30ae941d516927771889351160b00\">hemolytic</span> <span class=\"customMeta\" data-dictid=\"53bee2a41216927771814d7ec3a67f\">anemia</span> when exposed to certain triggers like medications, foods, or infections.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>G6PD catalyzes the conversion of glucose-6-phosphate to 6-phosphoglucono-δ-lactone, generating NADPH.</li>\n<li>NADPH is used to reduce oxidized <span class=\"customMeta\" data-dictid=\"f945849e691692777188ad7ce5b5e2\">glutathione</span> (GSSG) to its active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> (GSH), which neutralizes <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> stress in RBCs.</li>\n<li>Without G6PD, this protective mechanism is impaired, making RBCs more vulnerable to damage under <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">oxidative</span> stress</li>\n</ul>\n<p>.<img alt=\"G6PD deficiency\" data-author=\"\" data-hash=\"11137\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/lL2eKF3bSkTdw19XrkXk1745388686.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Triggers of Hemolysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs:</strong></p>\n<ul>\n<li><strong>Antimalarials: Primaquine, chloroquine</strong></li>\n<li>Sulfonamides: Sulfamethoxazole, sulfasalazine</li>\n<li>Antibiotics: Nitrofurantoin, dapsone</li>\n<li>Analgesics: High-dose aspirin, phenacetin</li>\n<li>Chemotherapeutics: Daunorubicin, doxorubicin</li>\n<li>Others: <span class=\"customMeta\" data-dictid=\"f1f83adcbd1692777192944952fb13\">Methylene</span> blue, rasburicase, certain NSAIDs</li>\n</ul>\n<p><strong>Other Causes:</strong></p>\n<ul>\n<li><strong>Fava beans (favism)</strong></li>\n<li>Infections: Certain <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> and bacterial infections</li>\n<li>Environmental Factors: Exposure to oxidizing agents, such as naphthalene</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>G6PD <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> → <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">Reduced</span> <span class=\"customMeta\" data-dictid=\"f945849e691692777188ad7ce5b5e2\">glutathione</span> levels decrease → <span class=\"customMeta\" data-dictid=\"60d563fe241692777194203742bf5b\">Oxidative</span> stress → <span class=\"customMeta\" data-dictid=\"c2b082746716927771888f0933941d\">Hemolysis</span> → <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> <span class=\"customMeta\" data-dictid=\"d30ae941d516927771889351160b00\">hemolytic</span> anemia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of dicumarol?", "options": [{"label": "A", "text": "Activates antithrombin III", "correct": false}, {"label": "B", "text": "Inhibits vitamin K-dependent clotting factors", "correct": true}, {"label": "C", "text": "Inhibits tissue plasminogen activator", "correct": false}, {"label": "D", "text": "Inhibitor of factor Xa", "correct": false}], "correct_answer": "B. Inhibits vitamin K-dependent clotting factors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Inhibits &lt;span class=\"customMeta\" data-dictid=\"71c2092f15169277720243eb1590b0\"&gt;vitamin K&lt;/span&gt; dependent &lt;span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\"&gt;Clotting&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The mechanism of action of tissue plasminogen activator is:", "options": [{"label": "A", "text": "Inhibit extrinsic pathway", "correct": false}, {"label": "B", "text": "Inhibits platelet aggregation", "correct": false}, {"label": "C", "text": "Enhance fibrin degradation", "correct": true}, {"label": "D", "text": "Inhibit clot formation", "correct": false}], "correct_answer": "C. Enhance fibrin degradation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/UMCrmvHcypVLhWedSk7X1745908352.png"], "explanation": "<p>Correct Answer C - Enhance &lt;span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\"&gt;fibrin&lt;/span&gt; deg\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a malignancy is undergoing chemotherapy; his platelet counts were reduced during the previous cycle of chemotherapy. What time will you give this to prevent/treat this condition?", "options": [{"label": "A", "text": "Oprelvekin (IL-11)", "correct": true}, {"label": "B", "text": "Filgrastim", "correct": false}, {"label": "C", "text": "Erythropoietin", "correct": false}, {"label": "D", "text": "Amifostine", "correct": false}], "correct_answer": "A. Oprelvekin (IL-11)", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"73e490ea3f1692777194b3e2311f72\"&gt;Oprelvekin&lt;/span&gt; (IL-11)\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hematopoietic drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Erythropoietin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates the production of red blood cells in the bone marrow</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anemia due to chronic <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> disease, cancer chemotherapy, <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> therapy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypertension, headache, nausea, vomiting, allergic reactions, thrombotic events</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Filgrastim </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates the production of neutrophils in the bone marrow</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neutropenia due to cancer <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> or <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> transplant</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bone pain, fever, headache, fatigue, nausea, vomiting</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sargramostim </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates the production of white blood cells, including neutrophils, monocytes, eosinophils, and <span class=\"customMeta\" data-dictid=\"77f797c5e8169277718535480fa7fd\">dendritic</span> cells</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neutropenia due to cancer <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> or <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> transplant, <span class=\"customMeta\" data-dictid=\"5b9831f3aa169277718395d7361df6\">bone marrow</span> failure syndromes</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bone pain, fever, headache, fatigue, nausea, vomiting, allergic reactions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Oprelvekin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates the production of platelets in the bone marrow</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thrombocytopenia due to cancer chemotherapy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Fluid retention, dyspnea, hypotension, allergic reactions, arrhythmias</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Eltrombopag </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates the production of platelets in the bone marrow</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Chronic immune thrombocytopenia, <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> C-induced thrombocytopenia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Headache, nausea, diarrhea, <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> liver function tests, thrombotic events.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young female comes to the emergency department after consuming 100 aspirin tablets. What should be the next step in management?", "options": [{"label": "A", "text": "N-acetyl cysteine to replenish glutathione stores", "correct": false}, {"label": "B", "text": "Pralidoxime", "correct": false}, {"label": "C", "text": "Glucagon to control bradycardia and hypoglycemia", "correct": false}, {"label": "D", "text": "Give sodium bicarbonate to alkalize urine", "correct": true}], "correct_answer": "D. Give sodium bicarbonate to alkalize urine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/e2Rd6RkF25hcMx3r0Yvh1745303240.png"], "explanation": "<p>Correct Answer D - Give sodium &lt;span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\"&gt;bicarbonate&lt;/span&gt; to &lt;span class=\"customMeta\" data-dictid=\"11dc8d57a01692777181568b2b8461\"&gt;alkalize&lt;/span&gt; u\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male patient presents with several purpuric skin lesions and is diagnosed with idiopathic thrombocytopenic purpura. Which of the following tyrosine kinase inhibitors can be used in this condition?", "options": [{"label": "A", "text": "Oprelvekin", "correct": false}, {"label": "B", "text": "Fostamatinib", "correct": true}, {"label": "C", "text": "Eltrombopag", "correct": false}, {"label": "D", "text": "Romiplostim", "correct": false}], "correct_answer": "B. Fostamatinib", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Immune Thrombocytopenic <span class=\"customMeta\" data-dictid=\"0acd34c758169277719644923511e5\">Purpura</span> (ITP)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Autoimmune disorder is characterized by a low <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> count (thrombocytopenia) due to immune system destruction of platelets.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Types </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Acute ITP: </strong>Typically occurs in children and often follows a <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> infection.</p>\n<p><strong>Chronic ITP: </strong>Persistent low <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> count, lasting more than 12 months, can affect both children and adults.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Petechiae and <span class=\"customMeta\" data-dictid=\"0acd34c758169277719644923511e5\">purpura</span> (bruising) on the skin (easy bruising and bleeding), especially from <span class=\"customMeta\" data-dictid=\"26080f047a169277719334625cadef\">mucous</span> membranes (spontaneous nosebleeds).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blood tests: <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">Platelet</span> count, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood smear</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Observation for mild cases without <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> symptoms</li>\n<li><strong>1st Line Treatment: </strong>Corticosteroids</li>\n<li><strong>2nd Line Therapies:</strong> IVIG (intravenous immunoglobulin)</li>\n<li>Anti-D <span class=\"customMeta\" data-dictid=\"f8fab286571692777189bdfd087071\">immunoglobulin</span> (Rho(D) immuno globulin)</li>\n<li>Thrombopoietin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonists (eltrombopag, romiplostim).</li>\n<li>Splenectomy (severe or <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> cases)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Severe bleeding, especially <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> in rare cases - Impaired quality of life due to <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> symptoms.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most useful drug to treat Doxorubicin-induced cardiotoxicity?", "options": [{"label": "A", "text": "Aprepitant", "correct": false}, {"label": "B", "text": "Deferoxamine", "correct": false}, {"label": "C", "text": "Amifostine", "correct": false}, {"label": "D", "text": "Dexrazoxane", "correct": true}], "correct_answer": "D. Dexrazoxane", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a 35-year-old female with sickle cell disease who presents with unprovoked pain in her extremities and torso, thromboembolic events are suspected. What is the initial medication that should be administered for prophylaxis of thromboembolic events in this patient?", "options": [{"label": "A", "text": "LMWH", "correct": true}, {"label": "B", "text": "Warfarin", "correct": false}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Dabigatran", "correct": false}], "correct_answer": "A. LMWH", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - LMWH\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is beneficial in reducing the painful crisis of sickle cell anemia?", "options": [{"label": "A", "text": "Methionine", "correct": false}, {"label": "B", "text": "Hydroxyurea", "correct": true}, {"label": "C", "text": "Methotrexate + Leucovorin", "correct": false}, {"label": "D", "text": "Eltrombopag", "correct": false}], "correct_answer": "B. Hydroxyurea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Hydroxyu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action (MOA) of Rivaroxaban?", "options": [{"label": "A", "text": "Inhibition of thrombin (Factor IIa)", "correct": false}, {"label": "B", "text": "Inhibition of Factor Xa", "correct": true}, {"label": "C", "text": "Activation of antithrombin III", "correct": false}, {"label": "D", "text": "Inhibition of platelet aggregation", "correct": false}], "correct_answer": "B. Inhibition of Factor Xa", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">Thrombin</span> Inhibitors</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> (factor IIa) directly without cofactors.</p>\n<p><strong>(Option A) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hirudin derivatives: </strong>Hirudin,<strong> Lepirudin.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-hirudin (Synthetic):</strong> Argatroban, Bivalirudin.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Indirect <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">Thrombin</span> Inhibitors</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enhance <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III activity to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> indirectly.</p>\n<p><strong>(Option C)</strong></p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Unfractionated Heparin: Heparin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Low Molecular Weight Heparin (LMWH):</strong> <strong>Enoxaparin,</strong> Dalteparin, Tinzaparin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ultra Low Molecular Weight Heparin (ULMWH):</strong> <strong>Fondaparinux,</strong> Idraparinux, Danaparoid (not commonly used)</p>\n</td>\n</tr>\n</tbody>\n\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Direct Factor Xa Inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit Factor Xa directly</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Apixaban,</strong> Rivaroxaban, Edoxaban, Betrixaban</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prophylaxis of <strong>venous thromboembolism</strong> following knee or hip replacement surgery.</li>\n<li>Prophylaxis of <strong>stroke</strong> in patients with <strong>atrial fibrillation.</strong></li>\n<li><strong>Treatment of deep <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> thrombosis</strong> and<strong> <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> embolism.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Advantages of novel anticoagulants over warfarin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rapid onset and offset of action.</li>\n<li>No need for routine laboratory monitoring.</li>\n<li>Lower risk of bleeding.</li>\n<li>Fewer drug interactions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on anti-cancer therapy developed an infection. Blood analysis revealed neutropenia. Which of the following drugs is likely to be effective in this patient?", "options": [{"label": "A", "text": "Romiplostim", "correct": false}, {"label": "B", "text": "Oprelvekin", "correct": false}, {"label": "C", "text": "Filgrastim", "correct": true}, {"label": "D", "text": "Epoetin alfa", "correct": false}], "correct_answer": "C. Filgrastim", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"961cab02fe1692777202b03db9637d\"&gt;Filgrastim&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Class </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Recombinant human <span class=\"customMeta\" data-dictid=\"a5e951c6221692777188d09fdd7e1a\">G-CSF</span> (Granulocyte colony-stimulating factor)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Stimulates colony-forming unit (CFU) granulocytes to increase <span class=\"customMeta\" data-dictid=\"000d23188716927771936c5f2fe74e\">neutrophil</span> production.</li>\n<li>Enhances <span class=\"customMeta\" data-dictid=\"b68a8f1b37169277719547f1cfda59\">phagocytic</span> and cytotoxic activities of neutrophils.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>To treat severe <span class=\"customMeta\" data-dictid=\"3925bbe5df1692777193bd03c159a8\">neutropenia</span> (after <span class=\"customMeta\" data-dictid=\"0a266da66816927771824d58668832\">autologous</span> <span class=\"customMeta\" data-dictid=\"d2e0ab499c169277718886ab5a46bf\">hematopoietic</span> stem cell transplantation, high-dose cancer chemotherapy, <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> neutropenias, and patients with AIDS receiving zidovudine)</li>\n<li>Used in patients undergoing <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> blood stem cell collection for stem cell transplantation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug acts on the rounded up enzyme?", "options": [{"label": "A", "text": "Aminocapric acid", "correct": true}, {"label": "B", "text": "Tenecteplase", "correct": false}, {"label": "C", "text": "Streptokinase", "correct": false}, {"label": "D", "text": "Apixaban", "correct": false}], "correct_answer": "A. Aminocapric acid", "question_images": ["https://image.prepladder.com/content/49xiCCgCoewjq8hfNZb11724836291.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following anticoagulants requires aPTT monitoring?", "options": [{"label": "A", "text": "Lepirudin", "correct": true}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Dabigatran", "correct": false}, {"label": "D", "text": "Apixaban", "correct": false}], "correct_answer": "A. Lepirudin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Lepiru\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For the action of heparin as an anticoagulant , availability of which of the following chemical substances is needed ?", "options": [{"label": "A", "text": "Thrombin", "correct": false}, {"label": "B", "text": "Plasmin", "correct": false}, {"label": "C", "text": "Antithrombin – III", "correct": true}, {"label": "D", "text": "Thrombomodulin", "correct": false}], "correct_answer": "C. Antithrombin – III", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Antithrombin-III\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is used in acute mountain sickness ?", "options": [{"label": "A", "text": "Dexamethasone", "correct": false}, {"label": "B", "text": "Digoxin", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Acetazolamide", "correct": true}], "correct_answer": "D. Acetazolamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug directly inhibits clotting factor Xa among the options provided?", "options": [{"label": "A", "text": "Apixaban", "correct": true}, {"label": "B", "text": "Argatroban", "correct": false}, {"label": "C", "text": "Fondaparinux", "correct": false}, {"label": "D", "text": "Aspirin", "correct": false}], "correct_answer": "A. Apixaban", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "To which class of drugs does Apixaban belong in?", "options": [{"label": "A", "text": "Antifibrinolytic", "correct": false}, {"label": "B", "text": "Factor Xa inhibitors", "correct": true}, {"label": "C", "text": "Oral direct thrombin inhibitor", "correct": false}, {"label": "D", "text": "Parenteral direct thrombin inhibitor", "correct": false}], "correct_answer": "B. Factor Xa inhibitors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Factor Xa inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements accurately describes prasugrel?", "options": [{"label": "A", "text": "It acts as an P2Y12 agonist", "correct": false}, {"label": "B", "text": "It is 10 times less potent than clopidogrel", "correct": false}, {"label": "C", "text": "It is a pro drug", "correct": true}, {"label": "D", "text": "Omeprazole interferes in its activation to an active metabolite", "correct": false}], "correct_answer": "C. It is a pro drug", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - It is a pro drug\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Target</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Drug </strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Action </strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Use </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\">\n<p><strong>GP IIb/IIa</strong></p>\n<p> </p>\n</td>\n<td>\n<p>Abicixmab (longer acting with short half time)</p>\n<ul>\n<li>\n<p>Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure with no dose reduction</p>\n</li>\n<li>\n<p>Adverse effects include <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and thrombocytopenia</p>\n</li>\n</ul>\n</td>\n<td>\n<p>High – <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of GP IIb/IIa and vitronectin</p>\n</td>\n<td>\n<ul>\n<li>\n<p>Acute <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> syndrome (ACS)</p>\n</li>\n<li>\n<p>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> and</p>\n</li>\n<li>\n<p>Percutaneous <span class=\"customMeta\" data-dictid=\"bc8bc758371692777185eff2ccabb7\">coronary</span> intervention (PCI)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<ul>\n<li>\n<p>Tirofiban</p>\n</li>\n<li>\n<p>Eptifibatide (injectable)</p>\n</li>\n</ul>\n</td>\n<td>\n<p> </p>\n</td>\n<td>\n<p>PCT and ACS</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\">\n<p><strong>P2Y12</strong></p>\n<p> </p>\n</td>\n<td>\n<p>Irreversible Antagonists:</p>\n<ul>\n<li>\n<p>Clopidogrel</p>\n</li>\n<li>\n<p>Prasugrel (faster)</p>\n</li>\n</ul>\n<p>Both are prodrugs:</p>\n<ul>\n<li>\n<p>Ticlopidine (adverse effect includes Diarrhoea)</p>\n</li>\n</ul>\n</td>\n<td>\n<p> </p>\n</td>\n<td>\n<ul>\n<li>\n<p>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> and stroke</p>\n</li>\n<li>\n<p>Myocardial <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> only (contraindicated in stroke)</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Reversible antagonists:</p>\n<ul>\n<li>\n<p>Cangrelor (I.V.)</p>\n</li>\n<li>\n<p>Ticagrelor</p>\n</li>\n</ul>\n</td>\n<td>\n<p> </p>\n</td>\n<td>\n<ul>\n<li>\n<p>PCI and ACS</p>\n</li>\n<li>\n<p>M.I. Prophylaxis</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>PAR</strong></p>\n</td>\n<td>\n<p>Vorapaxar and Atopaxar</p>\n</td>\n<td>\n<p> </p>\n</td>\n<td>\n<p>M.I. Prophylaxis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>TxA2</strong></p>\n</td>\n<td>\n<p>TxA2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</p>\n<ul>\n<li>\n<p>Terutroban</p>\n</li>\n<li>\n<p>Low soe <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> (40-325 mg)</p>\n</li>\n</ul>\n</td>\n<td>\n<ul>\n<li>\n<p>Undertrial</p>\n</li>\n<li>\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"cbe27145221692777185a3b125aa48\">cox</span> 1&amp; 2 <span class=\"customMeta\" data-dictid=\"ee77d507701692777190bfcf47b497\">irreversible</span> leading to decrease in TxA2</p>\n</li>\n</ul>\n</td>\n<td>\n<p>For M.I. (162-325mg)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Phosphodiesterase</strong></p>\n</td>\n<td>\n<p><strong>Inhibitors</strong>:</p>\n<ul>\n<li>\n<p>Cilastazole</p>\n</li>\n<li>\n<p>Dipyridamole</p>\n</li>\n</ul>\n</td>\n<td>\n<ul>\n<li>\n<p>Increase in cAMP leading to the <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> aggregation</p>\n</li>\n<li>\n<p>Increases <span class=\"customMeta\" data-dictid=\"d3f6a49b7416927771802124ccddf0\">adenosine</span> activity and decreases <span class=\"customMeta\" data-dictid=\"d3f6a49b7416927771802124ccddf0\">adenosine</span> uptake</p>\n</li>\n</ul>\n</td>\n<td>\n<ul>\n<li>\n<p>Peripheral <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> disease</p>\n</li>\n<li>\n<p>Stroke Prophylaxis</p>\n</li>\n<li>\n<p>Cardiac stress testing</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drugs require monitoring of the coagulation profile during therapy?", "options": [{"label": "A", "text": "Fondaparinux", "correct": false}, {"label": "B", "text": "Enoxaparin", "correct": false}, {"label": "C", "text": "Dabigatran", "correct": false}, {"label": "D", "text": "Lepirudin", "correct": true}], "correct_answer": "D. Lepirudin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Lepiru\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which one of the following drugs inhibits neutrophil recruitment ?", "options": [{"label": "A", "text": "Montelukast", "correct": false}, {"label": "B", "text": "Sodium cromolyn", "correct": false}, {"label": "C", "text": "Colchicine", "correct": true}, {"label": "D", "text": "Febuxostat", "correct": false}], "correct_answer": "C. Colchicine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Colch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is an oral factor Xa inhibitor ?", "options": [{"label": "A", "text": "Bivalirudin", "correct": false}, {"label": "B", "text": "Dabigatran", "correct": false}, {"label": "C", "text": "Rivaroxaban", "correct": true}, {"label": "D", "text": "Enoxaparin", "correct": false}], "correct_answer": "C. Rivaroxaban", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Riv\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Type of Anticoagulant</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Vitamin K antagonists(e.g., warfarin)</p>\n</td>\n<td>\n<p>Inhibit the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <span class=\"customMeta\" data-dictid=\"71c2092f15169277720243eb1590b0\">vitamin K</span> <span class=\"customMeta\" data-dictid=\"29ca44bd601692777187c3d92d645b\">epoxide</span> reductase, which is responsible for the conversion of <span class=\"customMeta\" data-dictid=\"71c2092f15169277720243eb1590b0\">vitamin K</span> <span class=\"customMeta\" data-dictid=\"29ca44bd601692777187c3d92d645b\">epoxide</span> to its active form. This inhibits the <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of vitamin K-dependent <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors II, VII, IX, and X.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Direct <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> inhibitors(e.g., dabigatran)</p>\n</td>\n<td>\n<p>Bind directly to <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> (factor IIa), inhibiting its ability to convert <span class=\"customMeta\" data-dictid=\"a137b7092a16927772025412d4ef05\">fibrinogen</span> to <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> and preventing <span class=\"customMeta\" data-dictid=\"56c933e0d41692777200b713c46640\">thrombus</span> formation.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Factor Xa inhibitors(e.g., rivaroxaban, apixaban)</p>\n</td>\n<td>\n<p>Inhibit the activity of factor Xa, which plays a key role in the <span class=\"customMeta\" data-dictid=\"42f1e4deb8169277718412c0681a54\">coagulation</span> <span class=\"customMeta\" data-dictid=\"6826aa04ef16927771833336e53730\">cascade</span> by converting <span class=\"customMeta\" data-dictid=\"94b02f097916927771962072dbeeac\">prothrombin</span> to thrombin. By inhibiting factor Xa, these drugs prevent the formation of <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> and subsequent <span class=\"customMeta\" data-dictid=\"5e0b40993316927771844dbf382689\">clot</span> formation.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Heparins(e.g., unfractionated heparin, low <span class=\"customMeta\" data-dictid=\"b2df2436bf1692777193d90e9c0132\">molecular weight</span> heparins)</p>\n</td>\n<td>\n<p>Enhance the activity of <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III, a natural <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> of <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors. This increases the <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of factors IIa (thrombin) and factor Xa, leading to decreased <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> activity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the suggested follow-up treatment for a patient post valve replacement?", "options": [{"label": "A", "text": "Warfarin", "correct": true}, {"label": "B", "text": "ACE inhibitors", "correct": false}, {"label": "C", "text": "Beta blockers", "correct": false}, {"label": "D", "text": "Thiazides", "correct": false}], "correct_answer": "A. Warfarin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\"&gt;Warfarin&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the options listed below is an oral medication that directly inhibits thrombin?", "options": [{"label": "A", "text": "Dabigatran", "correct": true}, {"label": "B", "text": "Rivaroxaban", "correct": false}, {"label": "C", "text": "Warfarin", "correct": false}, {"label": "D", "text": "Lepirudin", "correct": false}], "correct_answer": "A. Dabigatran", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Dabig\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "LMWH is given by which route?", "options": [{"label": "A", "text": "Intravenous", "correct": false}, {"label": "B", "text": "Subcutaneous", "correct": true}, {"label": "C", "text": "Intramuscular", "correct": false}, {"label": "D", "text": "Intradermal", "correct": false}], "correct_answer": "B. Subcutaneous", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Subcutaneou\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Route of Administration</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p><strong>Subcutaneous (SC)</strong></p>\n</td>\n<td>\n<p>LMWH is typically administered subcutaneously, injecting the medication into the <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> tissue layer just beneath the skin.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Intravenous (IV)</strong></p>\n</td>\n<td>\n<p>LMWH is not typically administered intravenously, as it can increase the risk of <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and other complications.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Intramuscular (IM)</strong></p>\n</td>\n<td>\n<p>LMWH is not administered intramuscularly, as it can cause pain, <span class=\"customMeta\" data-dictid=\"832849414c1692777188491f77bb5f\">hematoma</span> formation, and unpredictable absorption.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p><strong>Intradermal (ID)</strong></p>\n</td>\n<td>\n<p>LMWH is not administered intradermally, as it is not intended for local effects and may not be well absorbed through the skin.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 43 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the mechanism of action of Thiocyanate?", "options": [{"label": "A", "text": "Thyroid peroxidase inhibitor", "correct": false}, {"label": "B", "text": "Sodium Iodide symporter inhibitor (NIS)", "correct": true}, {"label": "C", "text": "Inhibit hormone release", "correct": false}, {"label": "D", "text": "Destruction of thyroid tissue", "correct": false}], "correct_answer": "B. Sodium Iodide symporter inhibitor (NIS)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/9L1kzMUzbPBe1Infcqms1724079344.png", "https://image.prepladder.com/content/nBrcOiiyLZA11DO787dJ1724079309.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:483px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit hormone <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> (Thioamides)</p>\n<p>(Thyroid <span class=\"customMeta\" data-dictid=\"b3434346d71692777195b113bbab37\">peroxidase</span> inhibitor) <strong>1</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Propylthiouracil</p>\n<p>Carbimazole</p>\n<p>Methimazole</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit <span class=\"customMeta\" data-dictid=\"7fa62c89591692777190c3b9e60490\">Iodide</span> trapping (Ionic inhibitors)</p>\n<p>(Sodium <span class=\"customMeta\" data-dictid=\"7fa62c89591692777190c3b9e60490\">Iodide</span> <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> inhibitors) <strong>2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thiocyanates (-SCN)</p>\n<p>Perchlorates (-CI04)</p>\n<p>Nitrates (-NO3)</p>\n<p>Fluoroborates</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit hormone release <strong>3</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>lodine</p>\n<p>Iodides of Na, K</p>\n<p>Organic iodide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Destroy <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> tissue <strong>4</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radioactive <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> I-131</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gz6NhzQMDBS5V8oNzDIx1749138015.mp3", "video": ""}, {"text": "A 28-year-old woman with a history of hyperthyroidism is 4 weeks pregnant and presents for a prenatal visit. Which of the following is the DOC in the first trimester of pregnancy?", "options": [{"label": "A", "text": "Propylthiouracil", "correct": true}, {"label": "B", "text": "Carbimazole", "correct": false}, {"label": "C", "text": "Methimazole", "correct": false}, {"label": "D", "text": "I-131", "correct": false}], "correct_answer": "A. Propylthiouracil", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3TQ4ubi937IYnnPj0Ban1749138122.mp3", "video": ""}, {"text": "A 6-month-old child is brought with the following defect over his scalp. Which of the following drugs, when used in the first trimester of pregnancy, is responsible for this condition?", "options": [{"label": "A", "text": "Carbimazole", "correct": true}, {"label": "B", "text": "Radioactive I-131", "correct": false}, {"label": "C", "text": "Iodine", "correct": false}, {"label": "D", "text": "Thiocyanate", "correct": false}], "correct_answer": "A. Carbimazole", "question_images": ["https://image.prepladder.com/content/wEv4QxRamv7KuiJjoSHK1724149620.png", "https://image.prepladder.com/content/SFUhMfjmBhgJoxyFA62I1719898283.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:728px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Propylthiouracil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbimazole (Prodrug of Methimazole)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less potent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5 x more potent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Highly <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein-bound</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein bound</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less transferred across the <span class=\"customMeta\" data-dictid=\"5276da31d11692777195f0e82f5e1d\">placenta</span> and in milk</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Large amounts transferred across the <span class=\"customMeta\" data-dictid=\"5276da31d11692777195f0e82f5e1d\">placenta</span> and in milk</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Plasma t½ 1-2 hours; Acts for 4-8 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Plasma t½ 6-10 hours; Acts for 12-24 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Multiple (2-3) daily doses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Single daily dose</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> T4 to T3 conversion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Does not <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> T4 to T3 conversion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC in first <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy.(Less teratogenic)<br/>\n\t\t\tC/I in 2nd and 3rd trimester.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC in 2nd and 3rd <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy.(Less hepatotoxic)</p>\n<p>C/I in first trimester.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eeekkV6hPkSAGDzvVfZe1749138216.mp3", "video": ""}, {"text": "Which of the following are the fastest-acting antithyroid drugs?", "options": [{"label": "A", "text": "Propylthiouracil", "correct": false}, {"label": "B", "text": "Sodium thiocyanate", "correct": false}, {"label": "C", "text": "Radioactive iodine", "correct": false}, {"label": "D", "text": "Potassium iodide", "correct": true}], "correct_answer": "D. Potassium iodide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:854px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Oral iodides</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhibits release of T3 and T4</li>\n<li>Decreases size of gland</li>\n<li>Decreases vasculogenesis</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Preoperatively in <span class=\"customMeta\" data-dictid=\"2d83e30a3b1692777200b79557c3e1\">thyroidectomy</span> to make the <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> less <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> and small</li>\n<li>Thyroid storm: To prevent further release of T3 and T4</li>\n<li>Endemic <span class=\"customMeta\" data-dictid=\"10ccb423ae1692777188f2ffbb4491\">goitre</span> prophylaxis</li>\n<li>Antiseptic: Tincture iodine, <span class=\"customMeta\" data-dictid=\"e4d4a6bec61692777196426007d1d4\">povidone</span> iodine</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute reaction in patients sensitive to iodine</li>\n<li>Angioedema, fever, joint pain, petechial haemorrhages, thrombocytopenia, lymphadenopathy</li>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"3f4eecb1c6169277719459c801fb19\">overdose</span> (iodism): Inflammation of <span class=\"customMeta\" data-dictid=\"26080f047a169277719334625cadef\">mucous</span> membranes, sialorrhea, rhinorrhoea, lacrimation, <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of eyelids, burning sensation in mouth, headache, rashes, GI symptoms</li>\n<li>Sialadenitis (mimics mumps)</li>\n<li>Hypothyroidism and goitre</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wHXz5QjMQAAJno0rD6W21748860656.mp3", "video": ""}, {"text": "Which type of thyroid cancer does radioactive iodine treat?", "options": [{"label": "A", "text": "Papillary thyroid carcinoma", "correct": false}, {"label": "B", "text": "Follicular thyroid carcinoma", "correct": false}, {"label": "C", "text": "Medullary thyroid carcinoma", "correct": false}, {"label": "D", "text": "Both A and B", "correct": true}], "correct_answer": "D. Both A and B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:851px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Radioactive iodine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> <span class=\"customMeta\" data-dictid=\"031a38f17a16927772036476ede2ae\">follicular</span> cells undergo <span class=\"customMeta\" data-dictid=\"bf97c6fd301692777196300645cf12\">pyknosis</span> and <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> followed by <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> without damage to neighbouring tissues</p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Thyroid scans</li>\n<li>Hyperthyroidism due to Graves' disease </li>\n<li>Hyperthyroidism due to toxic <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> goitre</li>\n<li>Follicular and <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">Papillary</span> Ca thyroid</li>\n<li>Highly effective for permanent cure for hyperthyroidism</li>\n<li>Mainly used for the treatment of <span class=\"customMeta\" data-dictid=\"df46bcd43116927771892090901263\">hyperthyroidism</span> in older patients and those with heart disease.</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Delayed hypothyroidism</li>\n<li>Radiation <span class=\"customMeta\" data-dictid=\"df0e1364a11692777200ed67550c12\">thyroiditis</span> - Causes release of preformed T3 and T4 into circulation, usually <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> but can worsen <span class=\"customMeta\" data-dictid=\"df46bcd43116927771892090901263\">hyperthyroidism</span> symptoms, and rarely cause <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> issues or <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> storm.</li>\n<li>C/I in pregnancy</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LasK9oRjWt1QGVljXDnd1749138469.mp3", "video": ""}, {"text": "A 38-year-old female with Graves' disease presents to the emergency department with severe agitation, palpitations, profuse sweating, and fever. On examination, she appears tremulous and diaphoretic with a heart rate of 160 bpm and a temperature of 103.1°F. Laboratory investigations reveal markedly elevated thyroid hormone levels. Which of the following is the drug of choice in this condition?", "options": [{"label": "A", "text": "Propranolol", "correct": true}, {"label": "B", "text": "Methimazole", "correct": false}, {"label": "C", "text": "Dexamethasone", "correct": false}, {"label": "D", "text": "Amiodarone", "correct": false}], "correct_answer": "A. Propranolol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose in <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">Thyroid</span> Storm</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Propranolol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-selective β-blocker; blocks T4 to T3 conversion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Controls HR, anxiety, tremors, and reduces T3 levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methimazole / PTU</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> hormone <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> (PTU also blocks T4 to T3 conversion)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prevents further hormone production</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dexamethasone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Corticosteroid; suppresses immune response; reduces T4 to T3 conversion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prevents <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> insufficiency; reduces T3 levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Iodine (after thionamides)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits release of <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> hormone (Wolff–Chaikoff effect)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks preformed hormone release (given after PTU)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YRUMQB8e4KYMSFUy34ow1747298010.mp3", "video": ""}, {"text": "A 67-year-old male with a long-standing history of hypothyroidism presents to the emergency department with altered mental status, hypothermia, bradycardia, and respiratory depression. His family reports increasing lethargy and confusion over the past week. He is unresponsive to stimuli. Labs reveal hyponatremia and elevated serum TSH levels. Which of the following is the DOC in this condition?", "options": [{"label": "A", "text": "Liothyronine (T3)", "correct": false}, {"label": "B", "text": "Levothyroxine (T4)", "correct": true}, {"label": "C", "text": "Teprotumumab", "correct": false}, {"label": "D", "text": "Cabozantinib", "correct": false}], "correct_answer": "B. Levothyroxine (T4)", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T3 (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>T4 (Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More potent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less potent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bioavailability</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100%</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>80%</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ROA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IV</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral/IV</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Shorter and faster acting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Longer-acting</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Along with T4 in <span class=\"customMeta\" data-dictid=\"a856fbe9fc1692777193631fa87f91\">myxedema</span> coma</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"a856fbe9fc1692777193631fa87f91\">Myxedema</span> <span class=\"customMeta\" data-dictid=\"e39842f67b1692777184171cd1852a\">coma</span> (IV), chronic <span class=\"customMeta\" data-dictid=\"8d4d1904791692777189941782330d\">hypothyroidism</span> (oral)</li>\n<li>Thyroid cancers to reduce TSH</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Half life</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>18-24 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>7-8 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Source</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>25% from gland, 75% from <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> conversion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>T4 is solely produced by gland</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Hvr19uKrD7pkaKJVku7h1749138589.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 17 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 35-year-old woman with severe rheumatoid arthritis has worsening joint pain, swelling, and stiffness despite taking methotrexate and an NSAID. The rheumatologist decides to add a corticosteroid to control inflammation. Which corticosteroid is the most appropriate, considering potency, duration, and side effects?", "options": [{"label": "A", "text": "Hydrocortisone", "correct": false}, {"label": "B", "text": "Betamethasone", "correct": false}, {"label": "C", "text": "Prednisolone ", "correct": true}, {"label": "D", "text": "Dexamethasone", "correct": false}], "correct_answer": "C. Prednisolone ", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Glucocorticoid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Potency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Effects/Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Short (8-12 hrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Hydrocortisone</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Physiological replacement therapy, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> insufficiency, anti-inflammatory</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Intermediate (12-36 hrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Cortisone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Anti-inflammatory, rheumatic disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Prednisone</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Intermediate</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Anti-inflammatory, immunosuppressive, rheumatic disorders, asthma, <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> diseases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Prednisolone</p>\n<p><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Intermediate to Long</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Methylprednisolone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Intermediate to High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Anti-inflammatory, immunosuppressive, severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conditions, multiple sclerosis.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Long </strong></p>\n<p><strong>(36-72 hrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dexamethasone</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>High</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Anti-inflammatory, immunosuppressive, severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conditions, cerebral edema.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Betamethasone <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Fludrocortisone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mineralocorticoid activity, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> insufficiency, salt-wasting disorders.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old woman, pregnant with twins, is hospitalised at 30 weeks with PPROM. To reduce the risk of respiratory distress syndrome (RDS) in preterm infants, the obstetrician decides to administer corticosteroids. Which corticosteroid regimen is recommended to promote fetal lung maturity?", "options": [{"label": "A", "text": "Betamethasone 12 mg IM every 24 hours for 2 doses", "correct": true}, {"label": "B", "text": "Dexamethasone 12 mg IM every 24 hours for 2 doses", "correct": false}, {"label": "C", "text": "Hydrocortisone 250 mg intravenous (IV) every 6 hours for 4 doses", "correct": false}, {"label": "D", "text": "Methylprednisolone 32 mg IM single dose", "correct": false}], "correct_answer": "A. Betamethasone 12 mg IM every 24 hours for 2 doses", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:539px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Betamethasone 12 mg IM every 24 hours for a total of 2 doses.</strong></li>\n</ul>\n<p style=\"text-align:center\"><strong>(OR)</strong></p>\n<ul>\n<li><strong>Dexamethasone 6 mg IM every 12 hours for a total of 4 doses </strong><strong>(Option B) </strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old woman with severe systemic lupus erythematosus (SLE) involving multiple organs presents with fatigue, joint pain, skin rashes, and signs of lupus nephritis. The rheumatologist plans high-dose corticosteroids to induce remission. What is the preferred dose of corticosteroid?", "options": [{"label": "A", "text": "Prednisone 60 mg daily", "correct": false}, {"label": "B", "text": "Methylprednisolone 1 g intravenous (IV) for 3 days", "correct": true}, {"label": "C", "text": "Dexamethasone 40 mg daily", "correct": false}, {"label": "D", "text": "Hydrocortisone 200 mg IV every 6 hours", "correct": false}], "correct_answer": "B. Methylprednisolone 1 g intravenous (IV) for 3 days", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:627px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Hydrocortisone</strong></p>\n<p style=\"text-align:center\"><strong>(Option D)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Adrenal suppression, increased risk of infections, fluid retention, hypertension.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Cortisone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Prednisone</strong></p>\n<p style=\"text-align:center\"><strong>(Option A)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Weight gain, osteoporosis, diabetes mellitus, <span class=\"customMeta\" data-dictid=\"98685f4edc1692777185b96ce8d9ca\">cushingoid</span> features, skin changes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Prednisolone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Methylprednisolone</strong></p>\n<p style=\"text-align:center\"><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Hypertension, hyperglycemia, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">electrolyte</span> imbalances (hypokalemia), psychiatric disturbances</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Dexamethasone</strong></p>\n<p style=\"text-align:center\"><strong>(Option C)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Psychiatric disturbances, <span class=\"customMeta\" data-dictid=\"98685f4edc1692777185b96ce8d9ca\">cushingoid</span> features, increased risk of infections.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Betamethasone</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Fludrocortisone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Hypertension, edema, hypokalemia.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DzBtU9j7PlIjyFSCAq3l1748860520.mp3", "video": ""}, {"text": "A 10-year-old boy with a widespread, itchy, erythematous rash on his arms, legs, and trunk has not found relief with over-the-counter hydrocortisone cream. Suspecting atopic dermatitis, the dermatologist prescribes a more potent topical steroid. Which topical steroid is most appropriate for this patient's condition and age?", "options": [{"label": "A", "text": "Hydrocortisone 0.5% cream", "correct": false}, {"label": "B", "text": "Triamcinolone 0.1% ointment.", "correct": true}, {"label": "C", "text": "Betamethasone 0.05% cream.", "correct": false}, {"label": "D", "text": "Clobetasol 0.05% ointment.", "correct": false}], "correct_answer": "B. Triamcinolone 0.1% ointment.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Topical Steroid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Typical Dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Efficacy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hydrocortisone</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.5% - 2.5% cream/ointment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mild</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mild <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> skin conditions in sensitive areas.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Triamcinolone</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.025% - 0.1% cream/ointment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Atopic dermatitis, contact dermatitis, psoriasis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Betamethasone</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.05% - 0.1% cream/ointment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> skin conditions, <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Clobetasol</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.05% cream/ointment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Very high</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Severe, recalcitrant cases, short-term use only.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Fluocinolone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.025% - 0.2% cream/ointment</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Moderate-high</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Atopic dermatitis, psoriasis, <span class=\"customMeta\" data-dictid=\"d176adf87f1692777191722064a021\">lichen</span> planus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Mometasone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>0.1% cream/ointment</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Atopic dermatitis, eczema, psoriasis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluticasone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0.005% - 0.05% cream/ointment</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 62-year-old man with type 2 diabetes and hypertension presents with severe nausea, vomiting, muscle cramps, fatigue, dizziness, dehydration, and blood pressure of 90/60 mmHg. Labs show hyponatremia, hyperkalemia, and metabolic acidosis. Which medication is most appropriate for his condition?", "options": [{"label": "A", "text": "Hydrocortisone", "correct": true}, {"label": "B", "text": "Fludrocortisone", "correct": false}, {"label": "C", "text": "Spironolactone", "correct": false}, {"label": "D", "text": "Dexamethasone", "correct": false}], "correct_answer": "A. Hydrocortisone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is Diethylstilbestrol (DES) classified as?", "options": [{"label": "A", "text": "Synthetic and nonsteroidal estrogen", "correct": true}, {"label": "B", "text": "Synthetic and steroidal estrogen", "correct": false}, {"label": "C", "text": "Natural and steroidal estrogen", "correct": false}, {"label": "D", "text": "Natural and nonsteroidal estrogen", "correct": false}], "correct_answer": "A. Synthetic and nonsteroidal estrogen", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:662px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Natural Estrogens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Steroidal <span class=\"customMeta\" data-dictid=\"61fbe2173416927771998e7aa0b432\">Synthetic</span> Estrogens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nonsteroidal <span class=\"customMeta\" data-dictid=\"61fbe2173416927771998e7aa0b432\">Synthetic</span> Estrogens</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Estradiol</li>\n<li>Estrone</li>\n<li>Estriol</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ethinylestradiol</li>\n<li>Mestranol</li>\n<li>Tibolone</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diethylstilbestrol</li>\n<li>Hexestrol</li>\n<li>Dienestrol</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:630px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect of Estrogen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reproductive Organ Regulation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Governs growth and function of female <span class=\"customMeta\" data-dictid=\"11e24b369816927771974383c7e17c\">reproductive</span> organs and <span class=\"customMeta\" data-dictid=\"3a03cad6c616927771925038b55989\">menstrual</span> cycles.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary Sexual Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prompts development of female secondary sexual characteristics during puberty.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bone Density Maintenance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It helps maintain <span class=\"customMeta\" data-dictid=\"0b2564673b16927771836152f83121\">bone density</span> by inhibiting bone <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> and promoting bone formation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiovascular</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It improves <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> health by regulating cholesterol levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Brain Function</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Influences cognitive function, memory, mood regulation, and emotional well-being.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin and Hair Health</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contributes to skin thickness, elasticity, hydration, and hair growth.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Urinary <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">Tract</span> Integrity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It supports the integrity of <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> tissues and may prevent <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> incontinence.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 54-year-old woman presents with a history of hormone receptor-positive breast cancer. She is prescribed tamoxifen as part of her adjuvant therapy regimen to reduce the risk of cancer recurrence. Which of the following best describes the mechanism of action of tamoxifen?", "options": [{"label": "A", "text": "It acts as a direct agonist on estrogen receptors in breast tissue.", "correct": false}, {"label": "B", "text": "It acts as an antagonist on estrogen receptors in breast tissue.", "correct": true}, {"label": "C", "text": "It inhibits aromatase enzyme activity.", "correct": false}, {"label": "D", "text": "It stimulates progesterone receptors in breast tissue.", "correct": false}], "correct_answer": "B. It acts as an antagonist on estrogen receptors in breast tissue.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:662px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Tamoxifen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Raloxifene</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Estrogen <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> (ER) Antagonist</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Binds to ER</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Tissue-specific effects such as :</p>\n<ul>\n<li>Antagonist in breast tissue (prevents <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> binding).</li>\n<li>Agonist in bone and <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> tissues (estrogen-like effects)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drug of choice for ER-positive breast cancer.</li>\n<li>Decrease the risk of <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> breast cancer.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevention of breast cancer.</li>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> osteoporosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased risk of endometrial cancer.</li>\n<li>Thromboembolism, hot flashes, depression, hepatotoxicity, cataracts.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>No increased risk of endometrial cancer.</li>\n<li>Hot flashes, depression. <span class=\"customMeta\" data-dictid=\"237b2a1dfa1692777200a074fd1072\">Thromboembolism</span> are seen</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It should not be combined with <span class=\"customMeta\" data-dictid=\"17dda67959169277720303cc6f5bc1\">fluoxetine</span> and other SSRIs.</li>\n<li>SSRIs <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the CYP2D6 enzyme, essential for converting tamoxifen into its active form, endoxifen.</li>\n<li>This interaction may lower endoxifen levels, diminishing tamoxifen's effectiveness against <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> receptor-positive breast cancer.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>No significant drug interactions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old female presents with infertility. She has irregular menstrual cycles and is suspected of having anovulation. She was started on Clomiphene citrate. Which of the following best describes the mechanism of action of this drug?", "options": [{"label": "A", "text": "Binds to estrogen receptors, exerting agonistic effects in breast tissues.", "correct": false}, {"label": "B", "text": "Acts as a SERM, exerting antagonist effects in the pituitary.", "correct": false}, {"label": "C", "text": "Inhibits aromatase enzyme activity, reducing estrogen synthesis.", "correct": false}, {"label": "D", "text": "Stimulates gonadotropin secretion by blocking estrogenic feedback inhibition of the pituitary.", "correct": true}], "correct_answer": "D. Stimulates gonadotropin secretion by blocking estrogenic feedback inhibition of the pituitary.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clomiphene Citrate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Blocking of <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> receptors in <span class=\"customMeta\" data-dictid=\"32b8d1e25c1692777189a123d50ec1\">hypothalamus</span> by Clomiphene citrate</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Removal of <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> feedback inhibition</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Increased GnRH <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> from the hypothalamus</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Increased <span class=\"customMeta\" data-dictid=\"02315055441692777203a721dd9b19\">FSH</span> and LH <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> from the pituitary</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Stimulation of ovarian <span class=\"customMeta\" data-dictid=\"b0c3f6b8901692777203d0446fe1f4\">follicle</span> growth</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Ovulation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"e259c6641e1692777190c1be1c1842\">infertility</span> due to failure of ovulation, often in cases of <span class=\"customMeta\" data-dictid=\"ba336eb30516927771960f9d9bd85c\">polycystic</span> <span class=\"customMeta\" data-dictid=\"7b1a7ff355169277719401475de6fb\">ovary</span> syndrome (PCOS) or unexplained infertility.</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"d7e5f3488b1692777182a0c5bc3641\">assisted <span class=\"customMeta\" data-dictid=\"11e24b369816927771974383c7e17c\">reproductive</span> technology</span> (ART) procedures.</li>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"fb9775227e16927771948ac6b7f4a7\">oligozoospermia</span> in men, where it increases <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> secretion, promoting <span class=\"customMeta\" data-dictid=\"a3b0e644a6169277719912525dffae\">spermatogenesis</span> and <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> secretion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Polycystic ovaries</li>\n<li>Multiple pregnancies</li>\n<li>Hot flashes</li>\n<li>Vertigo</li>\n<li>Allergic dermatitis</li>\n<li>Increased risk of ovarian tumour</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs, whose half-life is 46 hours, primarily acts as an aromatase inhibitor?", "options": [{"label": "A", "text": "Clomiphene", "correct": false}, {"label": "B", "text": "Tamoxifen", "correct": false}, {"label": "C", "text": "Letrozole", "correct": true}, {"label": "D", "text": "Fulvestrant", "correct": false}], "correct_answer": "C. Letrozole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:684px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Letrozole</strong></p>\n<p style=\"text-align:center\"><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Inhibition of <span class=\"customMeta\" data-dictid=\"b249ba1c6a16927771821b83b1fd9b\">Aromatase</span> Enzyme</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Reduction in <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Synthesis</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Decreased <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Levels in circulation.</p>\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\">The <span class=\"customMeta\" data-dictid=\"082d1526db1692777188311b6eef04\">half-life</span> of <span class=\"customMeta\" data-dictid=\"7a910d548c1692777191b14a31103d\">Letrozole</span> is 46 hours</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Breast cancer treatment</p>\n<p style=\"text-align:center\">Ovulation induction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Hot flashes, joint pain, bone loss.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Clomiphene</strong></p>\n<p style=\"text-align:center\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Blocks <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Receptors in the Hypothalamus</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Prevents <span class=\"customMeta\" data-dictid=\"267c66363316927771936565b4c6a4\">Negative Feedback</span> Inhibition</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Increased Release of Gonadotropins (FSH and LH) from Pituitary</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Stimulation of Ovulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Ovulation induction.</p>\n<p style=\"text-align:center\">Infertility in women.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Hot flashes, <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> upset, multiple pregnancies.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Tamoxifen</strong></p>\n<p style=\"text-align:center\"><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Selective <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"a4dd3586e816927771927d01e3fe29\">modulator</span> (SERM)</p>\n<ul>\n<li style=\"text-align:center\">Antagonist in breast tissue.</li>\n<li style=\"text-align:center\">Agonist in bone and <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> tissues.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Breast cancer treatment and prophylaxis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Endometrial hyperplasia, risk of endometrial carcinoma, and <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> thromboembolism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\"><strong>Fulvestrant</strong></p>\n<p style=\"text-align:center\"><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Binding to <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Receptors (ER)</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">ER <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">Degradation</span> and Downregulation</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Inhibition of ER <span class=\"customMeta\" data-dictid=\"f9016f36fd1692777198b0fd5e9c6d\">Signaling</span> Pathways</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Decreased Estrogen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Advanced breast cancer treatment.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align:center\">Injection site reactions, nausea, liver impairment.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which progestin type is characterized by both estrogenic and androgenic actions?", "options": [{"label": "A", "text": "Medroxyprogesterone acetate", "correct": false}, {"label": "B", "text": "Norethindrone", "correct": true}, {"label": "C", "text": "Levonorgestrel", "correct": false}, {"label": "D", "text": "Cyproterone", "correct": false}], "correct_answer": "B. Norethindrone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Actions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Medroxyprogesterone acetate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">No significant <span class=\"customMeta\" data-dictid=\"f5499837d31692777187477cd15613\">estrogenic</span> activity.</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\">Nausea, breast tenderness, <span class=\"customMeta\" data-dictid=\"3a03cad6c616927771925038b55989\">menstrual</span> changes, headache, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, fatigue, dizziness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Levonorgestrel</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Has minimal <span class=\"customMeta\" data-dictid=\"f5499837d31692777187477cd15613\">estrogenic</span> activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Norethindrone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Exhibits weak <span class=\"customMeta\" data-dictid=\"f5499837d31692777187477cd15613\">estrogenic</span> and <span class=\"customMeta\" data-dictid=\"6b8cd2ccb91692777181ea2591a76a\">androgenic</span> activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Similar to medroxyprogesterone acetate, but with the addition of possible <span class=\"customMeta\" data-dictid=\"6b8cd2ccb91692777181ea2591a76a\">androgenic</span> side effects such as acne, hirsutism, and changes in libido.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Cyproterone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Has antiandrogenic activity: Blocks <span class=\"customMeta\" data-dictid=\"426898277b1692777181c2186c29da\">androgen</span> receptors and inhibits <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> production.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Menstrual changes, breast tenderness, weight changes, mood changes, decreased libido, <span class=\"customMeta\" data-dictid=\"5cc2a2112e16927771874c5d97065a\">erectile</span> dysfunction, depression (rare but severe).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old woman with endometriosis comes to the clinic as her symptoms have not been relieved by first-line drugs. Which of the following drugs can be tried to provide relief to her symptoms?", "options": [{"label": "A", "text": "Nandrolone", "correct": false}, {"label": "B", "text": "Danazol", "correct": true}, {"label": "C", "text": "Methyltestosterone", "correct": false}, {"label": "D", "text": "Letrozole", "correct": false}], "correct_answer": "B. Danazol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:599px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Androgenic Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Methyltestosterone</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Androgen replacement therapy in hypogonadism</li>\n<li>Hypopituitarism</li>\n<li>Testicular failure</li>\n<li>Idiopathic male infertility</li>\n<li>Delayed <span class=\"customMeta\" data-dictid=\"c284c4252f16927771963c07a95e13\">puberty</span> in boys</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Testosterone undecanoate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cachexia in <span class=\"customMeta\" data-dictid=\"fa9d83d3d41692777189a8b393dd60\">HIV</span> or cancer patients.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anabolic steroid</p>\n<ul>\n<li>Nandrolone <strong>(Option A)</strong></li>\n<li>Oxymetholone</li>\n<li>Stanozolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bodybuilding</li>\n<li>Catabolic states such as <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> illness, major surgery</li>\n<li>Malignancy associated anemia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 70-year-old man who was diagnosed with metastatic prostatic cancer was started on combined androgen deprivation (CAD) therapy. Which of the following anti-androgenic drugs are used in combined androgen deprivation to prevent initial flare-ups due to initial LH and testosterone production due to GnRH agonist use?", "options": [{"label": "A", "text": "Flutamide", "correct": true}, {"label": "B", "text": "Finasteride", "correct": false}, {"label": "C", "text": "Ketoconazole", "correct": false}, {"label": "D", "text": "Cyproterone acetate", "correct": false}], "correct_answer": "A. Flutamide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:682px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Anti <span class=\"customMeta\" data-dictid=\"6b8cd2ccb91692777181ea2591a76a\">androgenic</span> Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Flutamide </strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-steroidal <span class=\"customMeta\" data-dictid=\"426898277b1692777181c2186c29da\">androgen</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blocker</p>\n<p>It also increases LH secretion.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CAB therapy for metastatic <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer.</li>\n<li>Female hirsutism.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hepatotoxic</li>\n<li>Gynecomastia</li>\n<li>Breast tenderness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bicalutamide </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Same as <span class=\"customMeta\" data-dictid=\"e02544c9c41692777203b9a58332e1\">Flutamide</span> but more potent and has a longer half-life</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metastatic <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Less hepatotoxic</li>\n<li>Hot flashes</li>\n<li>Chills</li>\n<li>Oedema</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cyproterone acetate</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Weak <span class=\"customMeta\" data-dictid=\"426898277b1692777181c2186c29da\">androgen</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> with <span class=\"customMeta\" data-dictid=\"7c8c2c290d16927771962e60fde698\">progestational</span> activity. It suppresses LH secretion.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Precocious <span class=\"customMeta\" data-dictid=\"c284c4252f16927771963c07a95e13\">puberty</span> in boys</li>\n<li>Female hirsutism</li>\n<li>Oral <span class=\"customMeta\" data-dictid=\"ec56ec0a50169277718538a912cf18\">contraception</span> in combination with ethinylestradiol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hepatotoxic</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ketoconazole </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"5fb22d02a41692777199b904eb168e\">steroidogenic</span> CYP450 enzyme, thus inhibiting <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> production</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antifungal agent</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiandrogenic effects include gynaecomastia and ↓ libido.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Finasteride </strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5 alpha-reductase <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> thus reduces the conversion of <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> to DHT.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Benign prostatic hyperplasia.</li>\n<li>Androgenic <span class=\"customMeta\" data-dictid=\"5cac5dbe851692777181a2373219b0\">alopecia</span> .</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old man comes to the dermatologist with complaints of progressive thinning of hair for 3 years. His family has a history of male-pattern baldness. A diagnosis of androgenic alopecia was made, for which he was prescribed topical Minoxidil. What is the mechanism of action of this drug?", "options": [{"label": "A", "text": "Blockade of 5 alpha-reductase enzyme, thus preventing DHT formation.", "correct": false}, {"label": "B", "text": "Ornithine decarboxylase enzyme inhibitor, which is found in the hair follicles.", "correct": false}, {"label": "C", "text": "Blockade of androgenic receptors along with progestational activity.", "correct": false}, {"label": "D", "text": "K+ channel opening leads to vasodilation of microvessels around the hair follicles.", "correct": true}], "correct_answer": "D. K+ channel opening leads to vasodilation of microvessels around the hair follicles.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:661px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Options</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Finasteride/Dutasteride</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5<strong>α </strong>reductase <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> inhibitor, which prevents the conversion of <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> to dihydrotestosterone.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Benign prostatic hyperplasia.</li>\n<li>Androgenic <span class=\"customMeta\" data-dictid=\"5cac5dbe851692777181a2373219b0\">alopecia</span> (oral <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> and not <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> as a <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> agent)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eflornithine</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It inhibits the <span class=\"customMeta\" data-dictid=\"3387bea7f916927771943c70507aae\">ornithine</span> <span class=\"customMeta\" data-dictid=\"71aa164f75169277718559680376bd\">decarboxylase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> found in the hair follicle, thus slowing hair growth and serving as a hair depilator.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Topical agent to remove excessive <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> hair in <span class=\"customMeta\" data-dictid=\"b1cab43c3216927771897f8f15cbbd\">Hirsutism</span> in females,</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cyproterone acetate</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The weak <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> of <span class=\"customMeta\" data-dictid=\"6b8cd2ccb91692777181ea2591a76a\">androgenic</span> receptors with <span class=\"customMeta\" data-dictid=\"7c8c2c290d16927771962e60fde698\">progestational</span> activity.</li>\n<li>It also suppresses LH secretion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Female hirsutism.</li>\n<li>Precocious <span class=\"customMeta\" data-dictid=\"c284c4252f16927771963c07a95e13\">puberty</span> in boys.</li>\n<li>Inappropriate sexual behavior in men.</li>\n<li>Oral <span class=\"customMeta\" data-dictid=\"ec56ec0a50169277718538a912cf18\">contraception</span> in combination with ethinylestradiol.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 56-year-old woman complains of hot flashes that interfere with her daily activities and sleep. Considering her history of recurrent thromboembolism, which of the following drugs would be appropriate for the treatment of her post-menopausal hot flashes?", "options": [{"label": "A", "text": "Hormone replacement therapy with estrogen", "correct": false}, {"label": "B", "text": "Clonidine", "correct": false}, {"label": "C", "text": "Paroxetine", "correct": true}, {"label": "D", "text": "Bazedoxifene", "correct": false}], "correct_answer": "C. Paroxetine", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 48-year-old man comes to the OPD due to his inability to maintain a penile erection during sexual intercourse. He was prescribed Sildenafil to help with his erectile dysfunction. What is the mechanism of action of this drug?", "options": [{"label": "A", "text": "Inhibition of phosphodiesterase-5 enzyme, thus increasing cytosolic cGMP levels.", "correct": true}, {"label": "B", "text": "Central alpha-2 agonist, reducing sympathetic outflow and causing vasodilation.", "correct": false}, {"label": "C", "text": "Inhibition of phosphodiesterase-3 enzyme, thus increasing cytosolic cAMP levels.", "correct": false}, {"label": "D", "text": "Peripheral alpha-blocker reduces vascular resistance and improve blood flow.", "correct": false}], "correct_answer": "A. Inhibition of phosphodiesterase-5 enzyme, thus increasing cytosolic cGMP levels.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:542px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Sildenafil</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Inhibits phosphodiesterase-5 (PDE-5) enzyme</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Prevents <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> degradation</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Increases cytosolic <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> levels</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Prolongs <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of GMP-dependent protein kinase</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Inhibits <span class=\"customMeta\" data-dictid=\"99c8e09d6f1692777193d7716ab6eb\">myosin</span> <span class=\"customMeta\" data-dictid=\"578fe8d7dd16927771913c847ed254\">light chain</span> <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> dephosphorylation</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Smooth muscle <span class=\"customMeta\" data-dictid=\"5bc49d94df16927771975eae86de9f\">relaxation</span> in the <span class=\"customMeta\" data-dictid=\"7e902103fb16927771857729aade8b\">corpus</span> cavernosum</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Increased blood flow</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Sustained penile erection</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:425px\">\n<tbody>\n<tr>\n<td style=\"vertical-align:top\">\n<ul>\n<li>Blue-green colour blindness</li>\n<li>Non Arteritic ischaemic <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"2d9476094c16927771933bcb162f19\">neuropathy</span> (NA ION)</li>\n<li>Priapism</li>\n<li>Flushing</li>\n</ul>\n</td>\n<td style=\"vertical-align:top\">\n<ul>\n<li>Nasal congestion</li>\n<li>Dyspepsia</li>\n<li>Hypotension</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 65-year-old male patient with a history of metastatic lung cancer presents to the emergency department with symptoms of nausea, vomiting, fatigue, and confusion. Blood tests reveal a significantly elevated serum calcium level. The patient is diagnosed with hypercalcemia of malignancy. Which of the following is the drug of choice for treating this condition?", "options": [{"label": "A", "text": "Cinacalcet", "correct": false}, {"label": "B", "text": "Denosumab", "correct": false}, {"label": "C", "text": "Zoledronic acid", "correct": true}, {"label": "D", "text": "Calcitonin", "correct": false}], "correct_answer": "C. Zoledronic acid", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NdA8lpRVvRhR0U0cjk7T1745662834.mp3", "video": ""}, {"text": "A 30-year-old pregnant woman at 28 weeks of gestation presents to the emergency department with complaints of regular uterine contractions. A tocolytic agent is used to produce uterine relaxation. From the list of tocolytics given below, identify the mismatched drug and its mechanism of action.", "options": [{"label": "A", "text": "Terbutaline; β2 selective antagonist", "correct": true}, {"label": "B", "text": "Nifedipine; Calcium channel blocker", "correct": false}, {"label": "C", "text": "Atosiban; Oxytocin receptor antagonist", "correct": false}, {"label": "D", "text": "Magnesium sulfate; Competes with calcium for entry into the myometrium", "correct": false}], "correct_answer": "A. Terbutaline; β2 selective antagonist", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adrenergic agonist</p>\n<p>(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ritodrine</p>\n<p>Terbutaline</p>\n<p>Salbutamol</p>\n<p>Isoxsuprine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>β2 selective <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> resulting in myometrial relaxation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Arrhythmia</p>\n<p>Hypotension</p>\n<p>Hyperglycemia</p>\n<p>Hyperinsulinemia</p>\n<p>Hyperkalemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium channel blocker</p>\n<p>(Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nifedipine</p>\n<p>Nicardipine</p>\n<p>Felodipine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks L type <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> channels thus prevents <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> entry into the myometrium.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tachyarrhythmia</p>\n<p>Hypotension</p>\n<p>Fetal <span class=\"customMeta\" data-dictid=\"a249eeb5551692777189661d39c1b2\">hypoxia</span> may occur</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxytocin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</p>\n<p>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atosiban</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"7e1c459d2b1692777194da47cd13b3\">oxytocin</span> receptors in the uterus, thus preventing <span class=\"customMeta\" data-dictid=\"ac9f7287191692777196e8c02d1f3d\">preterm</span> contraction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea</p>\n<p>Vomiting</p>\n<p>Headache</p>\n<p>(Safe to use in <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> disease)</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Other drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MgSO4</p>\n<p>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Magnesium competes with <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> for entry into the myometrium, thus causing <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> relaxation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not used as a <span class=\"customMeta\" data-dictid=\"f802dcf2ab1692777200eaf645d10c\">tocolytic</span> due to the risk of <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> demise</p>\n<p>Used to prevent and treat seizures in pre-eclampsia and eclampsia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Indomethacin</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is an <span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\">NSAID</span> that decreases <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> formation, thus causing <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> relaxation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in &lt; 32 weeks POG, <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">Premature</span> <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> of <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus if used in &gt;32 weeks.</p>\n<p>(in &gt;32 weeks POG - <span class=\"customMeta\" data-dictid=\"7c0ddaeead1692777193d6ef9ffbf0\">Nifedipine</span> is commonly used)</p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following uterine stimulant drugs with their mechanism of action Drugs Mechanism of action 1. Oxytocin A. 15-Methyl PGF2 alpha receptor stimulation 2. Carboprost B. Partial agonist at alpha-adrenergic and 5-HT2 receptors 3. Methergine C. GPCR IP3/DAG pathway activation 4. Misoprostol D. PGE1 receptor stimulation", "options": [{"label": "A", "text": "1-B, 2-A, 3-D, 4-C", "correct": false}, {"label": "B", "text": "1-D, 2-B, 3-A, 4-C", "correct": false}, {"label": "C", "text": "1-A, 2-C, 3-B, 4-D", "correct": false}, {"label": "D", "text": "1-C, 2-A, 3-B, 4-D", "correct": true}], "correct_answer": "D. 1-C, 2-A, 3-B, 4-D", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:696px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oxytocin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">GPCR activation</p>\n<p style=\"text-align:center\"> ↓</p>\n<p style=\"text-align:center\">IP3/DAG pathway</p>\n<p style=\"text-align:center\"> ↓</p>\n<p style=\"text-align:center\">Calcium influx into myometrial cells</p>\n<p style=\"text-align:center\"> ↓</p>\n<p style=\"text-align:center\">Uterine contraction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC in</p>\n<ul>\n<li>Induction and <span class=\"customMeta\" data-dictid=\"b51a3255901692777182fc797ec427\">augmentation</span> of labour.</li>\n<li>First line for <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> haemorrhage.</li>\n</ul>\n<p>Other uses</p>\n<ul>\n<li>Uterine inertia</li>\n<li>Breast <span class=\"customMeta\" data-dictid=\"02316c22e31692777187878aa0e0f7\">engorgement</span> due to ineffective milk letdown reflex.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Injudicious use can lead to\n\t\t\t\t<ul>\n<li>Uterine rupture</li>\n<li>Placental retention</li>\n<li>Fetal injury</li>\n</ul>\n</li>\n<li>Large doses can lead to water intoxication.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carboprost </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">15-Methyl PGF2 <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Uterine contraction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> haemorrhage that is resistant to <span class=\"customMeta\" data-dictid=\"7e1c459d2b1692777194da47cd13b3\">oxytocin</span> and methergine.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and vomiting</li>\n<li>Watery diarrhoea</li>\n<li>Flushing</li>\n<li>Hypotension</li>\n<li>Uterine cramps</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methergine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partial agonists at alpha-adrenergic and 5-HT2 receptors cause an increase in <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> tone and contraction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To prevent <span class=\"customMeta\" data-dictid=\"3d885759d516927771966b84bfa470\">postpartum</span> haemorrhage.</p>\n<p>To ensure normal <span class=\"customMeta\" data-dictid=\"2a4713707c1692777190062b13e806\">involution</span> of the uterus.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Vasospasm</li>\n<li>Angina</li>\n<li>Muscle cramps</li>\n<li>Paresthesia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Misoprostol </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PGE1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> stimulation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cervical ripening</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and vomiting</li>\n<li>Watery diarrhoea</li>\n<li>Flushing</li>\n<li>Hypotension</li>\n<li>Uterine cramps</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An 8-year-old female comes to the OPD due to the onset of menstrual bleeding. After investigation, a diagnosis of precocious puberty is established The doctor prescribes her injections of Goserelin. How should the injection be administered for the management of precocious puberty?", "options": [{"label": "A", "text": "Intermittent weekly injection of Goserelin", "correct": false}, {"label": "B", "text": "Continuous daily injection of Goserelin", "correct": true}, {"label": "C", "text": "Single dose of Goserelin", "correct": false}, {"label": "D", "text": "There is no specific method of administration of Goserelin", "correct": false}], "correct_answer": "B. Continuous daily injection of Goserelin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:636px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Intermittent injection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Continuous injection</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This is used when increased <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> is needed. As an agonist, its initial action stimulates the GnRH receptors, resulting in the release of gonadotropins.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This is preferred when decreased levels of gonadotropins or sex hormones are needed. Continuous <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> results in a <span class=\"customMeta\" data-dictid=\"267c66363316927771936565b4c6a4\">negative feedback</span> mechanism on the receptors, leading to their downregulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC in Delayed puberty.</li>\n<li>Azoospermia (Male Infertility).</li>\n<li>Anovulation (Female Infertility).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">Prostate</span> carcinoma.</li>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"58aedbfaa916927771960c11064ef0\">Precocious</span> puberty.</li>\n<li>Endometriosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased size of the <span class=\"customMeta\" data-dictid=\"7b1a7ff355169277719401475de6fb\">ovary</span> may lead to pain in the abdomen.</li>\n<li>Rupture of the ovary: Hemoperitoneum.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Postmenopausal symptoms include hot flashes, <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">Osteoporosis</span> and Depression.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old man with difficulty in micturition and dull lower abdominal pain comes to the OPD. Investigations reveal prostate cancer, and the patient is prescribed a GnRH antagonist.Which of the following drugs is a GnRH antagonist?", "options": [{"label": "A", "text": "Goserelin", "correct": false}, {"label": "B", "text": "Leuprolide", "correct": false}, {"label": "C", "text": "Ganirelix", "correct": true}, {"label": "D", "text": "Finasteride", "correct": false}], "correct_answer": "C. Ganirelix", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:649px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>GnRH antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>GnRH <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> GnRH antagonist</p>\n<p> ↓</p>\n<p> Blocks the GnRH <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> in the pituitary</p>\n<p> ↓</p>\n<p> Decreased <span class=\"customMeta\" data-dictid=\"02315055441692777203a721dd9b19\">FSH</span> and LH levels</p>\n<p> ↓</p>\n<p> Decreased <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> and Progesterone</p>\n<p> </p>\n<ul>\n<li>They have a lower risk of ovarian hyperstimulation.</li>\n<li>They offer complete <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> gonadotropins.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"> GnRH agonist</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\"> Initial <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> of <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> release</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Downregulation of GnRH receptors</p>\n<p style=\"text-align:center\">↓</p>\n<p style=\"text-align:center\">Suppression of <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> release</p>\n<ul>\n<li>Recovery occurs after 2-3 months of the stoppage of medication.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #ffffff; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cetrorelix</li>\n<li>Ganirelix</li>\n<li>Degarelix</li>\n<li>Abarelix</li>\n<li>Elagolix</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leuprolide (Option B)</li>\n<li>Goserelin (Option A)</li>\n<li>Histrelin</li>\n<li>Buserelin</li>\n<li>Triptorelin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prostate cancer.</li>\n<li>Endometriosis.</li>\n<li>In Vitro <span class=\"customMeta\" data-dictid=\"2a8e411e2116927772022dd4b365bc\">Fertilization</span> (Suppression of <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">Gonadotropin</span> before administration of <span class=\"customMeta\" data-dictid=\"18a9d4c52716927771878ee08e63ee\">exogenous</span> hormones).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Delayed puberty</li>\n<li>Precocious puberty</li>\n<li>Anovulation</li>\n<li>Endometriosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:547px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>GnRH antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>GnRH agonists</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #ffffff; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cetrorelix</li>\n<li>Ganirelix</li>\n<li>Degarelix</li>\n<li>Abarelix</li>\n<li>Elagolix</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leuprolide</li>\n<li>Goserelin</li>\n<li>Histrelin</li>\n<li>Buserelin</li>\n<li>Triptorelin</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 24-year-old woman comes to the OPD with complaints of galactorrhea and irregular menses. Investigation reveals a pituitary mass, and a diagnosis of prolactinoma was made. Which of the following is the drug of choice for prolactinoma?", "options": [{"label": "A", "text": "Cabergoline", "correct": true}, {"label": "B", "text": "Bromocriptine", "correct": false}, {"label": "C", "text": "Ropinirole", "correct": false}, {"label": "D", "text": "Pergolide", "correct": false}], "correct_answer": "A. Cabergoline", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:743px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>DRUGS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>USES</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>SIDE EFFECTS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cabergoline</p>\n<p>(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D2 agonist, selective for <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> lactotrophs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prolactinoma</li>\n<li>Acromegaly</li>\n<li>Post-abortion <span class=\"customMeta\" data-dictid=\"4abd8094e51692777191b1eb073735\">lactation</span> suppression</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and vomiting</li>\n<li>Postural <span class=\"customMeta\" data-dictid=\"9402185d4b1692777189cb62891ff1\">hypotension</span> Psychosis</li>\n<li>Ergotism.</li>\n<li>Peritoneal and pleural fibrosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bromocriptine</p>\n<p>(Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D2 agonist</p>\n<p>D1 partial agonist</p>\n<p>Weak <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> blocker</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prolactinoma</li>\n<li>Parkinsonism</li>\n<li>Acromegaly</li>\n<li>Diabetes mellitus</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Early\n\t\t\t\t<ul>\n<li>Postural hypotension</li>\n<li>Constipation</li>\n<li>Nausea and vomiting</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Late\n\t\t\t\t<ul>\n<li>Hallucination</li>\n<li>Psychosis</li>\n<li>Mental alteration</li>\n<li>Livedo reticularis</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ropinirole</p>\n<p>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Selective D2/D3 agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Parkinson disease (oral drug)</li>\n<li>Restless leg syndrome (Now <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for Restless Leg syndrome- Gabapentin)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and vomiting</li>\n<li>Postural hypotension</li>\n<li>Impulsive behaviour.</li>\n<li>Sexual hyperactivity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pergolide</p>\n<p>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D2 agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Parkinson disease</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Valvular heart disease/Cardiac <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> fibrosis.</p>\n<p>(thus no longer used)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is NOT true about octreotide?", "options": [{"label": "A", "text": "It is 40 times more potent than somatostatin in suppressing growth hormones.", "correct": false}, {"label": "B", "text": "Octreotide is preferred over Terlipressin for managing oesophagal variceal bleeding.", "correct": true}, {"label": "C", "text": "It is the drug of choice for carcinoid syndrome.", "correct": false}, {"label": "D", "text": "It has a risk of developing gallbladder stones due to biliary stasis.", "correct": false}], "correct_answer": "B. Octreotide is preferred over Terlipressin for managing oesophagal variceal bleeding.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:626px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces Growth hormone <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> due to <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> action on the pituitary.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acromegaly</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">glucagon</span> and <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> secretion.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagonoma / insulinoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces Gastrointestinal <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">motility</span> and <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> of <span class=\"customMeta\" data-dictid=\"9e7aec9ff416927771984a1e3100b7\">secretory</span> hormones such as CCK, VIP and serotonin.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Secretory diarrhoea in VIPoma,</p>\n<p><strong>Carcinoid syndrome (DOC: Octreotide) (Option C)</strong>,</p>\n<p>Short <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome,</p>\n<p>Cancer-induced diarrhoea.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"a74252404f1692777196d3f24bde2d\">portal</span> pressure by decreasing <span class=\"customMeta\" data-dictid=\"dbdb1e19591692777199e0d8fb2522\">splanchnic</span> blood flow.</p>\n<p>(But terlipressin is preferred over <span class=\"customMeta\" data-dictid=\"e705e1d6aa1692777194f6571628c6\">octreotide</span> as it is more effective).<strong> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oesophageal <span class=\"customMeta\" data-dictid=\"d4607865bb1692777201a35341db81\">variceal</span> bleed.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old man presents with enlarged hands and feet, coarse facial features, and elevated IGF-1 levels. He reports increasing shoe and ring size, excessive sweating, joint pain, and a deepening voice. An oral glucose tolerance test fails to suppress growth hormone, and an MRI shows a pituitary macroadenoma. Which drug targets the cause of these symptoms and biochemical abnormalities?", "options": [{"label": "A", "text": "Somatropin", "correct": false}, {"label": "B", "text": "Bromocriptine", "correct": false}, {"label": "C", "text": "Cabergoline", "correct": false}, {"label": "D", "text": "Pegvisomant", "correct": true}], "correct_answer": "D. Pegvisomant", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Primary Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Octreotide</strong></p>\n<p>(Option A)</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits growth hormone <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> by binding to <span class=\"customMeta\" data-dictid=\"375b0300101692777198a7a620f697\">somatostatin</span> receptors.</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:justify\">First-line medical therapy for acromegaly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lanreotide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bromocriptine </strong>(Option B)</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces growth hormone <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> by binding to <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> receptors.</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mixed <span class=\"customMeta\" data-dictid=\"760a997a7b1692777196db9355b82a\">prolactin</span> and growth hormone-secreting adenomas.</p>\n<p>Bromocriptine is DOC for <span class=\"customMeta\" data-dictid=\"795cb0cee2169277719625a59d84b0\">prolactinoma</span> in pregnancy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cabergoline</strong></p>\n<p>(Option C)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pegvisomant </strong></p>\n<p>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks the action of <span class=\"customMeta\" data-dictid=\"7a1ae24f701692777187a7f60bbd9f\">excess</span> growth hormone at the <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> level.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targeted therapy for acromegaly</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Somatostatin analogs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Octreotide; Lanreotide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dopamine agonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bromocriptine;Cabergoline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Growth hormone <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pegvisomant</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-year-old boy visits a pediatric endocrinologist due to short stature. His height is below the 3rd percentile for his age, and his growth rate has been slower than normal. Which of the following medications would be most appropriate for treating dwarfism caused by a growth hormone deficiency?", "options": [{"label": "A", "text": "Mecasermin", "correct": false}, {"label": "B", "text": "Somatropin", "correct": true}, {"label": "C", "text": "IGF - 1", "correct": false}, {"label": "D", "text": "Sermorelin", "correct": false}], "correct_answer": "B. Somatropin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug of Choice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">GH <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> (pituitary cause)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Somatropin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recombinant human GH – acts like <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> GH</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GH-deficient short stature, Turner syndrome, CKD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">GH <span class=\"customMeta\" data-dictid=\"f1fcf0370516927771902bff983613\">insensitivity</span> (e.g., Laron syndrome)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mecasermin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recombinant <strong>IGF-1</strong> – used when GH is ineffective</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IGF-1 deficiency, GH <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> defects</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">GH-releasing hormone deficiency</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sermorelin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GHRH <span class=\"customMeta\" data-dictid=\"517ff2aa92169277718110c734526d\">analog</span> – stimulates <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> to <span class=\"customMeta\" data-dictid=\"7b8c92219216927771981950fdd0e8\">secrete</span> GH</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rarely used today; GH therapy preferred</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">IGF-1 replacement</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IGF-1 (Mecasermin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct IGF-1 administration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used when low IGF-1 levels, especially in GH resistance</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1xPHiE1w51a65gTenDRY1748805068.mp3", "video": ""}, {"text": "Which phosphate binder is most appropriate for a 55-year-old man with end-stage renal disease (ESRD) on hemodialysis who has persistent hyperphosphatemia despite dietary phosphate restriction and has a history of coronary artery disease and coronary artery bypass grafting (CABG) 3 years ago?", "options": [{"label": "A", "text": "Vitamin D", "correct": false}, {"label": "B", "text": "Sevelamer", "correct": true}, {"label": "C", "text": "Teriparatide", "correct": false}, {"label": "D", "text": "Abalaoparatide", "correct": false}], "correct_answer": "B. Sevelamer", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Calcium based</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Non-calcium based</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium Carbonate</p>\n<p>Calcium Acetate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sevelamer</p>\n<p>Lanthanum Carbonate</p>\n<p>Sucroferric Oxyhydroxide</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old postmenopausal woman presents with a history of multiple fragility fractures. She has been previously treated for osteoporosis but continues to experience bone loss. Which medication would be most appropriate to stimulate bone formation in this patient?", "options": [{"label": "A", "text": "Bisphosphonates", "correct": false}, {"label": "B", "text": "Calcitonin", "correct": false}, {"label": "C", "text": "Denosumab", "correct": false}, {"label": "D", "text": "Teriparatide", "correct": true}], "correct_answer": "D. Teriparatide", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:633px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pharmacological Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bisphosphonates </strong> (Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Interfere with <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity, leading to decreased bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Calcitonin</strong> (Option B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Inhibits <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity, reducing bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Denosumab</strong> (Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">It inhibits the RANK ligand, essential for <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> formation and function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Estrogen/Raloxifene</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Inhibit <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity and slow bone loss.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cinacalcet</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Indirectly reduces <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> levels. (by stimulating CaSR receptors)</p>\n<p style=\"text-align: center;\"> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Teriparatide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">A <span class=\"customMeta\" data-dictid=\"b566321fe8169277719716b1cf4df0\">recombinant</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> stimulates <span class=\"customMeta\" data-dictid=\"8e55f8d71d1692777194a10c3d3d9d\">osteoblast</span> activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Strontium Ranelate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dual action:</strong> It promotes bone formation by stimulating osteoblasts and decreases <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by inhibiting <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/z7sSKEtm0757eL5YScsI1749201987.mp3", "video": ""}, {"text": "A 58-year-old postmenopausal woman with a family history of osteoporosis is concerned about her risk of developing the condition. She is reluctant to start bisphosphonate therapy due to concerns about potential side effects. Which of the following medications would be the most appropriate choice for this patient?", "options": [{"label": "A", "text": "Raloxifene", "correct": true}, {"label": "B", "text": "Clomiphene", "correct": false}, {"label": "C", "text": "Tamoxifen", "correct": false}, {"label": "D", "text": "Lasofoxifene", "correct": false}], "correct_answer": "A. Raloxifene", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M0HWTpITPzg5TgvsoWmi1749203212.mp3", "video": ""}, {"text": "How does pramlintide reduce blood glucose levels?", "options": [{"label": "A", "text": "Directly stimulating pancreatic beta cells to increase insulin secretion.", "correct": false}, {"label": "B", "text": "Inhibits the SGLT2 transporter in the kidneys, increasing glucose excretion.", "correct": false}, {"label": "C", "text": "It delays gastric emptying, suppresses postprandial glucagon secretion, and promotes satiety.", "correct": true}, {"label": "D", "text": "Activating PPAR-gamma receptors, improving insulin sensitivity in peripheral tissues.", "correct": false}], "correct_answer": "C. It delays gastric emptying, suppresses postprandial glucagon secretion, and promotes satiety.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pramlintide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amylin analogue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pramlintide ⟶ Mimics <span class=\"customMeta\" data-dictid=\"57fb8c52881692777181db5ce5dba0\">Amylin</span> ⟶ Binds to <span class=\"customMeta\" data-dictid=\"57fb8c52881692777181db5ce5dba0\">Amylin</span> Receptors ⟶ <strong>Delays <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">Gastric</span> Emptying</strong> ⟶ <strong>Reduces <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">Postprandial</span> <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</strong> ⟶ Promotes <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">Satiety</span> ⟶ Decreased Food <span class=\"customMeta\" data-dictid=\"6cdcd39cf2169277719068e247e38d\">Intake</span> ⟶ Decreased <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">Postprandial</span> Blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">Glucose</span> Levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adjunct treatment in <span class=\"customMeta\" data-dictid=\"ebcb7136251692777201ef4b5c5718\">Type 1</span> and <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">Type 2</span> diabetes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Benefits</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Improved <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> (after meal) <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> control</li>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> variability</li>\n<li>Potential weight loss due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> appetite</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Headache</li>\n<li>Hypoglycemia (especially when used with insulin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C/I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastroparesis (delayed <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying)</li>\n<li>Hypoglycemia unawareness</li>\n<li>Poor <span class=\"customMeta\" data-dictid=\"5f8b7d103016927771806be7e4190b\">adherence</span> to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> regimen</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Must be used with <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> but not mixed in the same syringe</li>\n<li>Requires education on proper dosing and <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> management.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2guKZ8KxywCziDAbE75Q1749203043.mp3", "video": ""}, {"text": "Match the following monoclonal antibody;s with their respective mechanism of action. 1. Burosumab A. Inhibits RANKL, reducing osteoclast formation and activity. 2. Romosozumab B. Targets sclerostin, increasing bone formation and decreasing resorption. 3. Denosumab C. Inhibits fibroblast growth factor 23 (FGF23) 4. Rituximab D. Targets CD20 on B cells, leading to their depletion.", "options": [{"label": "A", "text": "1-C, 2-B, 3-A, 4-D", "correct": true}, {"label": "B", "text": "1-A, 2-B, 3-C, 4-D", "correct": false}, {"label": "C", "text": "1-B, 2-C, 3-D, 4-A", "correct": false}, {"label": "D", "text": "1-C, 2-B, 3-D, 4-C", "correct": false}], "correct_answer": "A. 1-C, 2-B, 3-A, 4-D", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Burosumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Inhibits <span class=\"customMeta\" data-dictid=\"3095c5f0fc1692777202eda8060779\">fibroblast</span> growth factor 23 (FGF23).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Romosozumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Targets sclerostin, increasing bone formation and decreasing resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Denosumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Inhibits RANKL, reducing <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> formation and activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Rituximab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Targets CD20 on B cells, leading to their <span class=\"customMeta\" data-dictid=\"7061e0e0051692777186ba9c5f27df\">depletion</span> and affecting <span class=\"customMeta\" data-dictid=\"f8406817f21692777183176660cf3d\">bone remodeling</span> indirectly.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:639px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Monoclonal antibody</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Denosumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action:</strong></p>\n<p>Denosumab → binds to RANKL (receptor <span class=\"customMeta\" data-dictid=\"a095f733351692777180a29940c98a\">activator</span> of nuclear factor kappa-B ligand) → Prevents the interaction between RANKL and its <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (RANK) on the surface of osteoclasts and <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> precursors → reduction in <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> formation, function, and survival → ↓ bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses:</strong></p>\n<ul>\n<li>Osteoporosis treatment in <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> women at high <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> risk.</li>\n<li>Enhancing bone mass in <span class=\"customMeta\" data-dictid=\"e48bb8abfa1692777192e3fa06774f\">men</span> with osteoporosis.</li>\n<li>Treat bone loss due to hormone <span class=\"customMeta\" data-dictid=\"eb788615bd16927771803d3841aa78\">ablation</span> therapy in <span class=\"customMeta\" data-dictid=\"e48bb8abfa1692777192e3fa06774f\">men</span> with <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer.</li>\n<li>Hypercalcemia in malignancy.</li>\n<li>Treatment of Giant cell tumour.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Burosumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action:</strong></p>\n<p>Burosumab (monoclonal antibody) → binds to and inhibits <span class=\"customMeta\" data-dictid=\"3095c5f0fc1692777202eda8060779\">fibroblast</span> growth factor 23 (FGF23) → ↑ <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> and ↑ production of active vitamin D.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses: </strong>Treatment of X-linked <span class=\"customMeta\" data-dictid=\"0768daa0be169277718906a2461894\">hypophosphatemia</span> (XLH) (not osteoporosis)</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Romosozumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action:</strong></p>\n<p>Romosozumab → inhibits sclerostin → ↑ bone formation and ↓ bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses: </strong>Osteoporosis in <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> women at high risk of fracture.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rituximab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action:</strong></p>\n<p>Rituximab → targets CD20 (a protein found on the surface of B-cells) → Destruction of B-cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses: </strong>B-cell non-Hodgkin's lymphoma, chronic lymphocytic leukaemia (CLL), and <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> diseases such as <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">rheumatoid</span> arthritis</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qH68wP5cMH3KVstN1jxN1749202740.mp3", "video": ""}, {"text": "Which of the following drugs is contraindicated in Paget's disease?", "options": [{"label": "A", "text": "Alendronate", "correct": false}, {"label": "B", "text": "Teriparatide", "correct": true}, {"label": "C", "text": "Denosumab", "correct": false}, {"label": "D", "text": "Calcitonin", "correct": false}], "correct_answer": "B. Teriparatide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:632px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alendronate</strong></p>\n<p><strong>(Bisphosphonates)</strong></p>\n<p>(Option A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Inhibits <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> mediated bone resorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osteoporosis</li>\n<li>Paget's disease </li>\n<li>Glucocorticoid-induced osteoporosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Esophageal irritation</li>\n<li>Atypical fractures</li>\n<li>Osteonecrosis of the jaw</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Denosumab</strong></p>\n<p>(Option C)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monoclonal <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> inhibits <span class=\"customMeta\" data-dictid=\"cebebc510416927771979a104a1d7b\">RANKL</span> to prevent bone resorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osteoporosis</li>\n<li>Bone metastases</li>\n<li>Hypercalcemia of malignancy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypocalcemia </li>\n<li>Infections</li>\n<li>Dermatitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcitonin</strong></p>\n<p>(Option D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity and bone resorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Osteoporosis</li>\n<li>Paget's disease</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nasal irritation</li>\n<li>Flushing</li>\n<li>Nausea</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/S2ClDu2r1NVZwq3Hvgt41749202822.mp3", "video": ""}, {"text": "Which of the following drugs is NOT a form of Vitamin D?", "options": [{"label": "A", "text": "Cholecalciferol", "correct": false}, {"label": "B", "text": "Calcitriol", "correct": false}, {"label": "C", "text": "Alfacalcidol", "correct": false}, {"label": "D", "text": "Cinacalcet", "correct": true}], "correct_answer": "D. Cinacalcet", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Vitamin D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Calcimimetic drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cholecalciferol</li>\n<li>Ergocalciferol</li>\n<li>Calciferol</li>\n<li>Doxercalciferol</li>\n<li>Alfacalcidol</li>\n<li>Maxacalcitol</li>\n<li>Paricalcitol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cinacalcet</li>\n<li>Etelcalcetide</li>\n<li>Evocalcet</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases intestinal <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> and phosphate.</li>\n<li>Promotes bone mineralisation by increasing <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> and <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> levels in blood.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Modulates the calcium-sensing <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (CaSR) activity on the <span class=\"customMeta\" data-dictid=\"3bcd005ca116927771941ae5bca4a8\">parathyroid</span> gland, leading to decreased <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> of PTH.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nutritional rickets</li>\n<li>Vitamin D-deficiency rickets</li>\n<li>Familial hypophosphatemia</li>\n<li>Osteomalacia</li>\n<li>Osteoporosis</li>\n<li>Hypoparathyroidism</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Secondary <span class=\"customMeta\" data-dictid=\"a21c150dc716927771893624a49628\">hyperparathyroidism</span> in <span class=\"customMeta\" data-dictid=\"e6dc8586b11692777184b083672593\">CKD</span> patients.</li>\n<li>Hypercalcemia in <span class=\"customMeta\" data-dictid=\"3bcd005ca116927771941ae5bca4a8\">parathyroid</span> carcinoma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitamin D is generally safe when taken in appropriate doses, but excessive <span class=\"customMeta\" data-dictid=\"6cdcd39cf2169277719068e247e38d\">intake</span> can lead to various adverse effects due to increased <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels in the blood:</p>\n<ul>\n<li>Hypercalciuria, Increased risk of stones,</li>\n<li>Nausea, vomiting, constipation.</li>\n<li>Arrhythmias.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypocalcemia (principal adverse event)</li>\n<li>Potential development of <span class=\"customMeta\" data-dictid=\"54e3c1e99a1692777180d25815de1c\">adynamic</span> bone disease if <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> level falls below 100 pg/mL.</li>\n<li>Potential increase in risk for upper <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> bleeding.</li>\n<li>Potential for QT interval prolongation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YRm7R7V5UD5qsWwl33nR1749202920.mp3", "video": ""}, {"text": "Which of the following side effects is not associated with the use of bisphosphonates?", "options": [{"label": "A", "text": "Hypercalcemia", "correct": true}, {"label": "B", "text": "Esophagitis", "correct": false}, {"label": "C", "text": "Osteonecrosis of Jaw", "correct": false}, {"label": "D", "text": "Thrombophlebitis", "correct": false}], "correct_answer": "A. Hypercalcemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:736px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Short term </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Long term </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Upper GI: nausea, dyspepsia, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, and gastritis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"ffadabff021692777194c8ebe87262\">Osteonecrosis</span> of jaw - Poor oral hygiene, <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> procedures or <span class=\"customMeta\" data-dictid=\"7b9d503a8a16927771852d3853e608\">denture</span> use, and prolonged exposure to high doses of IV bisphosphonates appear to increase the risk of ONJ development</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> phase reactions associated with IV <span class=\"customMeta\" data-dictid=\"5d3892bd481692777183797a2e7318\">bisphosphonate</span> therapy,it usually lasts 24 to 72 hours and is characterized by fever, myalgias, and arthralgias.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Atrial fibrillation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. Severe <span class=\"customMeta\" data-dictid=\"09b955b4f91692777193bd4080e7fc\">musculoskeletal</span> pain</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. Severe <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of bone turnover</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4. Hypocalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4. <span class=\"customMeta\" data-dictid=\"6aad7ac3ba16927771992f27501295\">Subtrochanteric</span> <span class=\"customMeta\" data-dictid=\"ab8a987431169277720229e09c01d7\">femoral</span> fractures.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5. <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">Ocular</span> inflammation-eg, uveitis, conjunctivitis, episcleritis, and <span class=\"customMeta\" data-dictid=\"9a95fd22241692777198f4de3bac1e\">scleritis</span> (rare)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:611px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bisphosphonate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse Effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Etidronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Interference with bone mineralisation, potential osteomalacia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Pamidronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Thrombophlebitis, bone pain, fever, leukopenia, flu-like symptom.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Alendronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Esophagitis, <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> erosion, <span class=\"customMeta\" data-dictid=\"db0b2c70cb1692777197d6e5e33d95\">retrosternal</span> pain, flatulence.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Ibandronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Risk of flu-like symptoms with <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> infusion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Risedronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Generally well-tolerated, potential for <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> upset.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Zoledronate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Severe hypocalcemia, nephrotoxicity, flu-like symptoms, <span class=\"customMeta\" data-dictid=\"ffadabff021692777194c8ebe87262\">osteonecrosis</span> of the jaw.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OnbMk1BR6uS4C7BCbEUz1749202182.mp3", "video": ""}, {"text": "A 65-year-old woman with a history of osteoporosis presents with severe bone pain and multiple vertebral fractures. She has previously undergone treatment that has failed. Which of the following bisphosphonates is most appropriate for this patient?", "options": [{"label": "A", "text": "Medronate", "correct": false}, {"label": "B", "text": "Pamidronate", "correct": false}, {"label": "C", "text": "Risedronate", "correct": false}, {"label": "D", "text": "Zoledronate", "correct": true}], "correct_answer": "D. Zoledronate", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>1st generation</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>2nd generation</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>3rd generation</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Etidronate</li>\n<li>Clodronate</li>\n</ul>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Alendronate</li>\n<li>Risedronate</li>\n<li>Ibandronate</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Zoledronic acid</li>\n<li>Pamidronate</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td colspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity and bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Frequency of administration</strong></p>\n</td>\n<td colspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More potent drugs require less frequent administration</p>\n<ul>\n<li>Alendronate: Given once a week.</li>\n<li>Risedronate: Given once a week.</li>\n<li>Ibandronate: Given once a month.</li>\n<li>Zoledronate: Given once a year.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a6yWKD6GoDgXV6VUjLF01748073539.mp3", "video": ""}, {"text": "Which medication is considered the drug of choice for the treatment of osteoporosis?", "options": [{"label": "A", "text": "Teriparatide", "correct": false}, {"label": "B", "text": "Bisphosphonates", "correct": true}, {"label": "C", "text": "Denosumab", "correct": false}, {"label": "D", "text": "Calcitonin", "correct": false}], "correct_answer": "B. Bisphosphonates", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Role of Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Osteoporosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Effective in preventing and treating <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> osteoporosis, age-related, idiopathic, and steroid-induced osteoporosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Paget's Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Arrest osteolytic lesions, reduce bone pain, and improve secondary symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hypercalcemia of Malignancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Lower <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels, especially in severe cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Metastatic Bone Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Arrest osteolytic lesions and reduce bone pain.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gOjBqeLrriT4v873wD881749202075.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 29 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Metformin is indicated in all of the following conditions except?", "options": [{"label": "A", "text": "Diabetic retinopathy", "correct": true}, {"label": "B", "text": "Polycystic ovary syndrome (PCOS)", "correct": false}, {"label": "C", "text": "Cushing Syndrome", "correct": false}, {"label": "D", "text": "Clozapine-induced glucose intolerance", "correct": false}], "correct_answer": "A. Diabetic retinopathy", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses of Metformin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>First-line oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> </strong>for the treatment of <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes mellitus.</li>\n<li>DOC: <strong>Prophylaxis in</strong> <strong>prediabetes</strong> or impaired <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> tolerance</li>\n<li>Metabolic syndrome</li>\n<li>DOC: Diabetes due to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> resistance\n\t\t\t\t<ul>\n<li>In PCOS: Metformin also promotes <span class=\"customMeta\" data-dictid=\"264a9eb50d1692777194427a13247b\">ovulation</span> <strong>(Option B)</strong></li>\n<li>Clozapine-induced DM/glucose intolerance <strong>(Option D)</strong></li>\n<li>Cushing syndrome<strong> (Option C)</strong></li>\n<li>Gestational diabetes</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2iHT34qHrKINIwhw64JE1749311140.mp3", "video": ""}, {"text": "How does pramlintide reduce blood glucose levels?", "options": [{"label": "A", "text": "Directly stimulating pancreatic beta cells to increase insulin secretion.", "correct": false}, {"label": "B", "text": "Inhibits the SGLT2 transporter in the kidneys, increasing glucose excretion.", "correct": false}, {"label": "C", "text": "It delays gastric emptying, suppresses postprandial glucagon secretion, and promotes satiety.", "correct": true}, {"label": "D", "text": "Activating PPAR-gamma receptors, improving insulin sensitivity in peripheral tissues.", "correct": false}], "correct_answer": "C. It delays gastric emptying, suppresses postprandial glucagon secretion, and promotes satiety.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:698px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pramlintide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Amylin analogue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pramlintide ⟶ Mimics <span class=\"customMeta\" data-dictid=\"57fb8c52881692777181db5ce5dba0\">Amylin</span> ⟶ Binds to <span class=\"customMeta\" data-dictid=\"57fb8c52881692777181db5ce5dba0\">Amylin</span> Receptors ⟶ <strong>Delays <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">Gastric</span> Emptying</strong> ⟶ <strong>Reduces <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">Postprandial</span> <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</strong> ⟶ Promotes <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">Satiety</span> ⟶ Decreased Food <span class=\"customMeta\" data-dictid=\"6cdcd39cf2169277719068e247e38d\">Intake</span> ⟶ Decreased <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">Postprandial</span> Blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">Glucose</span> Levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adjunct treatment in <span class=\"customMeta\" data-dictid=\"ebcb7136251692777201ef4b5c5718\">Type 1</span> and <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">Type 2</span> diabetes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Benefits</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Improved <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> (after meal) <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> control</li>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> variability</li>\n<li>Potential weight loss due to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> appetite</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Headache</li>\n<li>Hypoglycemia (especially when used with insulin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C/I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastroparesis (delayed <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying)</li>\n<li>Hypoglycemia unawareness</li>\n<li>Poor <span class=\"customMeta\" data-dictid=\"5f8b7d103016927771806be7e4190b\">adherence</span> to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> regimen</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is a <span class=\"customMeta\" data-dictid=\"53172b32401692777195efbbb6b2e8\">peptide</span> drug, therefore given in <span class=\"customMeta\" data-dictid=\"c3d7276c3e1692777190b4b6762dd0\">injectable</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> only.</li>\n<li>Must be used with <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> but not mixed in the same syringe</li>\n<li>Requires education on proper dosing and <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> management.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the correct mechanism by which epalrestat acts?", "options": [{"label": "A", "text": "Inhibits the production of sorbitol", "correct": true}, {"label": "B", "text": "Increases expression of GLUT-4 receptors", "correct": false}, {"label": "C", "text": "Stimulates amylin receptors in the brain", "correct": false}, {"label": "D", "text": "Activation of AMP-dependent protein kinase", "correct": false}], "correct_answer": "A. Inhibits the production of sorbitol", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/U63Rx2CfVIuTW3SlekMx1749310612.mp3", "video": ""}, {"text": "A patient who presented for an annual health checkup is found to have high blood glucose despite following lifestyle modifications. Which of the following is least likely to be used in managing this patient?", "options": [{"label": "A", "text": "Colesevelam", "correct": false}, {"label": "B", "text": "Bromocriptine", "correct": false}, {"label": "C", "text": "Indapamide", "correct": true}, {"label": "D", "text": "Telmisartan", "correct": false}], "correct_answer": "C. Indapamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eLK6SXpJPjsvh1Kfc6ci1749310700.mp3", "video": ""}, {"text": "A patient is recently diagnosed with type 2 diabetes mellitus and also found to have high triglyceride levels. Which of the following is the most appropriate drug for this patient?", "options": [{"label": "A", "text": "Fenofibrate", "correct": false}, {"label": "B", "text": "Ezetimibe", "correct": false}, {"label": "C", "text": "Icosapent ethyl", "correct": false}, {"label": "D", "text": "Saroglitazar", "correct": true}], "correct_answer": "D. Saroglitazar", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OKk97NoLkkoopWhUMMZl1749310834.mp3", "video": ""}, {"text": "A patient who is a known diabetic and on metformin came up for a review, which showed no improvement in his glycemic profile. He has also been diagnosed with heart failure and is on drugs for the same. Which of the following is the most appropriate add-on drug for this patient?", "options": [{"label": "A", "text": "Repaglinide", "correct": false}, {"label": "B", "text": "Empagliflozin", "correct": true}, {"label": "C", "text": "Saxagliptin", "correct": false}, {"label": "D", "text": "Glipizide", "correct": false}], "correct_answer": "B. Empagliflozin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2sY1RuTne6oLZrZgz7mj1749310964.mp3", "video": ""}, {"text": "A patient who is diagnosed with diabetes mellitus has been prescribed a drug which is a PPAR-gamma receptor agonist. All of the following are incorrect with respect to this group of drugs except?", "options": [{"label": "A", "text": "These drugs act by sensitizing skeletal muscles to insulin", "correct": true}, {"label": "B", "text": "These drugs reduce the production of adiponectin", "correct": false}, {"label": "C", "text": "The dose should be increased when combined with gemfibrozil", "correct": false}, {"label": "D", "text": "Play a supportive role in post-menopausal osteoporosis", "correct": false}], "correct_answer": "A. These drugs act by sensitizing skeletal muscles to insulin", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding alpha-glucosidase inhibitors is correct?", "options": [{"label": "A", "text": "Inhibits breakdown of complex carbohydrates", "correct": true}, {"label": "B", "text": "Weight gain is one of the common side effects", "correct": false}, {"label": "C", "text": "Acarbose enhances the absorption of digoxin leading to toxicity", "correct": false}, {"label": "D", "text": "Negligible risk to administer in patients with kidney disease", "correct": false}], "correct_answer": "A. Inhibits breakdown of complex carbohydrates", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 48-year-old diabetic patient was started on metformin. Before initiating therapy, his baseline serum creatinine was 0.9 mg/dL. At his annual follow-up, it has risen to 1.8 mg/dL. Considering this finding, what is the most appropriate next step in managing this patient?", "options": [{"label": "A", "text": "Continue metformin at the current dose and start sodium bicarbonate", "correct": false}, {"label": "B", "text": "Increase the dose of metformin", "correct": false}, {"label": "C", "text": "Discontinue metformin", "correct": true}, {"label": "D", "text": "Add another antidiabetic medication without changing the metformin dose", "correct": false}], "correct_answer": "C. Discontinue metformin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3wdW64yPF3rpn0rMmSsG1746258192.mp3", "video": ""}, {"text": "Which of the following classes of oral hypoglycemic drugs works by closing potassium channels in the pancreatic beta cells to increase insulin secretion?", "options": [{"label": "A", "text": "Rosiglitazone", "correct": false}, {"label": "B", "text": "Sitagliptin", "correct": false}, {"label": "C", "text": "Canagliflozin", "correct": false}, {"label": "D", "text": "Glimepiride", "correct": true}], "correct_answer": "D. Glimepiride", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sulfonylureas</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Site of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatic β cells</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type 2 Diabetes Mellitus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sulfonylureas ⟶ Bind to Receptors on Pancreatic β Cells ⟶ <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">Closure</span> of ATP-sensitive K<sup>+</sup> Channels ⟶ <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> <span class=\"customMeta\" data-dictid=\"dbaf58dd301692777186f2a8d7b3a0\">Depolarization</span> ⟶ Opening of Voltage-Gated Ca².+ Channels ⟶ Ca²<sup>+</sup> Influx ⟶ <span class=\"customMeta\" data-dictid=\"669e9c5b3c1692777187e4d465b868\">Exocytosis</span> of <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Granules ⟶ Increased <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">Secretion</span> ⟶ Lower Blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">Glucose</span> Levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st Generation</p>\n<ul>\n<li>Tolbutamide</li>\n<li>Chlorpropamide</li>\n</ul>\n<p>2nd Generation</p>\n<ul>\n<li>Glibenclamide</li>\n<li>Glipizide</li>\n<li>Gliclazide</li>\n</ul>\n<ul>\n<li>Glimepiride</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DI9ubOiR766Me7PXlqVY1749309793.mp3", "video": ""}, {"text": "Which of the following statements correctly describe the effects of metformin in the management of type 2 diabetes mellitus? Metformin stimulates the pancreatic receptors to increase insulin secretion. Metformin inhibits hepatic glucose production by inhibiting adenosine monophosphate kinase (AMPK). Metformin reduces both microvascular and macrovascular complications in type-2 diabetics. Metformin decreases lipid levels and increases insulin sensitivity in peripheral tissues. No effect on blood glucose levels during normoglycemic state.", "options": [{"label": "A", "text": "3, 4, and 5", "correct": true}, {"label": "B", "text": "1, 4 and 5", "correct": false}, {"label": "C", "text": "1, 3 and 2", "correct": false}, {"label": "D", "text": "2, 3 and 4", "correct": false}], "correct_answer": "A. 3, 4, and 5", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old male with type 2 diabetes mellitus managed on metformin presents to the clinic with increased blood glucose levels. Routine investigations revealed haemoglobin of 11 g/dL, serum creatinine of 2.3, and an estimated glomerular filtration rate (eGFR) of 30 mL/min/1.73 m 2 . Which of the following additional medications can be safely prescribed to this patient?", "options": [{"label": "A", "text": "Dapagliflozin", "correct": false}, {"label": "B", "text": "Saxagliptin", "correct": false}, {"label": "C", "text": "Linagliptin", "correct": true}, {"label": "D", "text": "Exenatide", "correct": false}], "correct_answer": "C. Linagliptin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Increase <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">Incretin</span> Levels</strong>: Prevents <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">degradation</span> of <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">incretin</span> hormones (GLP-1 and GIP)</li>\n<li><strong>Enhance Insulin Secretion</strong> from the <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> in response to meals. (no risk of hypoglycemia)</li>\n<li><strong>Reduce Glucagon Secretion</strong></li>\n<li>Maintain neutral weight</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> drug (type-2 diabetes)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Linagliptin: Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Teneligliptin: Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Vildagliptin: Hepatotoxic</li>\n<li>Alogliptin</li>\n<li>Sitagliptin</li>\n<li>Saxagliptin: <strong>(Option B)</strong>\n<ol>\n<li>Metabolised by CYP3A4, it has more drug interactions.</li>\n<li>Requires dose adjustment in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment.</li>\n<li>Risk of congestive heart failure.</li>\n</ol>\n</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li><strong>Pancreatitis</strong> (lesser than GLP-1)</li>\n<li>Risk of pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer (lesser than GLP-1)</li>\n<li>Arthritis, Nasopharyngitis:\n\t\t\t\t<ul>\n<li>Increase interleukins and cytokines levels (similar structure to CD26)</li>\n</ul>\n</li>\n<li>Hypersensitivity reactions: Steven-Johnson syndrome, angioedema</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/t10GXmnmstYeL2am7xjb1749310470.mp3", "video": ""}, {"text": "A 48-year-old patient with type 2 diabetes mellitus, previously managed with metformin, presents to the clinic with persistently elevated blood glucose levels. Considering the need to initiate a GLP-1 analogue, which options can be prescribed to accommodate the patient’s request for oral medication?", "options": [{"label": "A", "text": "Exenatide", "correct": false}, {"label": "B", "text": "Semaglutide", "correct": true}, {"label": "C", "text": "Dulaglutide", "correct": false}, {"label": "D", "text": "Liraglutide", "correct": false}], "correct_answer": "B. Semaglutide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:647px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>GLP-1 (glucagon-like peptide-1) analogues: (Drugs end with:- natide or - glutide)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>MOA</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Enhance <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in response to food intake, which helps manage <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> levels. (No <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> risk)</li>\n<li>Suppress <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</li>\n<li>Slow <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">Gastric</span> <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">Emptying</span> leads to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> food intake.</li>\n<li>Promote <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">satiety</span> and help with weight loss.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Type-2 diabetes mellitus</li>\n<li>Anti-obesity drug: <span class=\"customMeta\" data-dictid=\"5861d6a9c91692777191ad56ffae72\">Liraglutide</span> and Semaglutide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Injectables:</strong></p>\n<ol>\n<li>Exenatide: <strong>Shortest</strong> acting <strong>(OPTION A)</strong></li>\n<li>Lixisenatide: <strong>Albumin</strong> bound, longer acting</li>\n<li>Liraglutide <strong>(OPTION D)</strong></li>\n<li>Dulaglutide <strong>(OPTION C)</strong></li>\n<li>Albiglutide</li>\n</ol>\n<p><strong>Injectable and Oral Route:</strong></p>\n<ol>\n<li>Semaglutide: <strong>Longest-acting (OPTION B)</strong></li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li>Gallstones</li>\n<li><strong>Pancreatitis</strong></li>\n<li>Risk of <strong>Pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer</strong> (medullary <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> of the thyroid): contraindicated in <strong>MEN syndrome </strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GTYleJGmJ0aSrWUYbGlG1749310361.mp3", "video": ""}, {"text": "A 55-year-old male with a history of long-standing type 2 diabetes mellitus presents to the clinic with features suggestive of short bowel syndrome following abdominal surgical resection for bowel ischemia. He complains of chronic diarrhoea, malabsorption, and significant weight loss. His current diabetes management includes insulin therapy. Which of the following medications would be most appropriate to manage his diabetes in addition to addressing his condition?", "options": [{"label": "A", "text": "Metformin", "correct": false}, {"label": "B", "text": "Pramlintide", "correct": false}, {"label": "C", "text": "Sitagliptin", "correct": false}, {"label": "D", "text": "Teduglutide", "correct": true}], "correct_answer": "D. Teduglutide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Teduglutide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Type</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peptide hormone (GLP-2 <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> )</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Teduglutide ⟶ Binds to GLP-2 Receptors on Intestinal Epithelial Cells ⟶ <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">Activation</span> of <span class=\"customMeta\" data-dictid=\"deb73df780169277718873138a593e\">Guanylate</span> <span class=\"customMeta\" data-dictid=\"b638747a661692777185a6182d6e5f\">Cyclase</span> ⟶ Increased Production of <span class=\"customMeta\" data-dictid=\"a5a4a70213169277718461b8cf22a6\">cGMP</span> ⟶ <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">Activation</span> of Protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">Kinase</span> G⟶ Regulation of Tight Junctions and Epithelial Transporters ⟶ Enhanced Intestinal <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">Absorption</span> of Fluid and Nutrients ⟶ Improved <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">Glycemic</span> Control.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Uses</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment of short <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome (SBS) in adult patients who are dependent on <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> support.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Benefits</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reduces <span class=\"customMeta\" data-dictid=\"01be542e8e16927771861e861ab536\">dependence</span> on <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> nutrition</li>\n<li>Improves intestinal <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> and transit time</li>\n<li>Increases nutrient <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> and fluid balance</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Headache</li>\n<li>Upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Contraindications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastrointestinal <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> or perforation</li>\n<li>Gastrointestinal cancer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Special Points</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Requires <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> injection</li>\n<li>Dosing and adjustment should be based on individual patient responses.</li>\n<li>Regular monitoring of nutritional status and <span class=\"customMeta\" data-dictid=\"98d46770fc1692777202253fb59fe9\">fluid balance</span> is essential.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IFGqyrteL5J8MTo3W96s1748860861.mp3", "video": ""}, {"text": "Which of the following drugs has a mechanism of action similar to sulfonylureas?", "options": [{"label": "A", "text": "Repaglinide", "correct": true}, {"label": "B", "text": "Pioglitazone", "correct": false}, {"label": "C", "text": "Acarbose", "correct": false}, {"label": "D", "text": "Metformin", "correct": false}], "correct_answer": "A. Repaglinide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:639px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Repaglinide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Meglitinide Analogue</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type 2 DM</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Meglitinide Analogue⟶ Bind to Receptors on Pancreatic β Cells ⟶ <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">Closure</span> of ATP-sensitive K+ Channels ⟶ <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> <span class=\"customMeta\" data-dictid=\"dbaf58dd301692777186f2a8d7b3a0\">Depolarization</span> ⟶ Opening of Voltage-Gated Ca²+ Channels ⟶ Ca²+ Influx ⟶ <span class=\"customMeta\" data-dictid=\"669e9c5b3c1692777187e4d465b868\">Exocytosis</span> of <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Granules ⟶ Increased <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypoglycemia</li>\n<li>Weight gain</li>\n<li>Headache</li>\n<li>Diarrhoea,</li>\n<li>Back pain</li>\n<li>cardiovascular events (e.g., myocardial ischemia)</li>\n<li>Liver <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> abnormalities</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CXnG4P1F8NJ8paCvBBYw1749310133.mp3", "video": ""}, {"text": "All of the following adverse reactions are associated with chlorpropamide except?", "options": [{"label": "A", "text": "Hypoglycemia", "correct": false}, {"label": "B", "text": "Hyponatremia", "correct": false}, {"label": "C", "text": "Disulfiram like reaction", "correct": false}, {"label": "D", "text": "Hypertension", "correct": true}], "correct_answer": "D. Hypertension", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Chlorpropamide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sulfonylurea (<strong>First Generation)</strong></p>\n<ul>\n<li>Less commonly used</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hypoglycemia</strong></li>\n<li>Gastrointestinal disturbances</li>\n<li>Weight gain</li>\n<li><strong>Hyponatremia (Increased release of ADH)</strong></li>\n<li><strong>Photosensitivity</strong></li>\n<li>Hepatic dysfunction</li>\n<li>Blood dyscrasias (Leukopenia, Thrombocytopenia, or <span class=\"customMeta\" data-dictid=\"d30ae941d516927771889351160b00\">Hemolytic</span> anaemia)</li>\n<li>Allergic reaction (Itching, hives)</li>\n<li>Disulfiram like reaction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It may interact with NSAIDs, MAOIs, and Beta-blockers, potentially altering <span class=\"customMeta\" data-dictid=\"88b48cf7241692777183e5f5b8adf1\">blood sugar</span> control.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Type 1 diabetes</li>\n<li>Diabetic Ketoacidosis</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> or liver disease</li>\n<li>Hypersensitivity to sulfonylureas</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/avND3SHG40XCqaDDYG7w1749310021.mp3", "video": ""}, {"text": "Which of the following sulfonylureas is considered the most potent?", "options": [{"label": "A", "text": "Tolbutamide", "correct": false}, {"label": "B", "text": "Chlorpropamide", "correct": false}, {"label": "C", "text": "Glimepiride", "correct": true}, {"label": "D", "text": "Glipizide", "correct": false}], "correct_answer": "C. Glimepiride", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:479px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Starting Dose</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tolbutamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First-generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>500 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chlorpropamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>First-generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low–Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100–250 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glipizide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Second-generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate–High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2.5–5 mg</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glimepiride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third-generation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Highest</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1 mg</strong></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sulfonylureas</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Special Points</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p><strong>First Generation</strong></p>\n<ul>\n<li>Higher risk of hypoglycemia</li>\n<li>Less commonly used</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p>Tolbutamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<ul>\n<li>Short-acting</li>\n<li>Lower potency</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chlorpropamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long-acting</li>\n<li>Antidiuretic effects.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tolazamide</p>\n</td>\n<td style=\"border-bottom:3px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intermediate duration</li>\n<li>More potent.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p><strong>Second Generation</strong></p>\n<ul>\n<li>More potent than first-generation drugs</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<p>Glibenclamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:3px solid #000000; vertical-align:top\">\n<ul>\n<li>longer duration</li>\n<li>There is a higher risk of <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> compared to other second-generation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glipizide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Shorter half-life</li>\n<li>Lower risk of hypoglycemia</li>\n<li>Preferable in elderly patients or those with <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glimepiride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Once-daily dosing,</li>\n<li>Lower risk of hypoglycemia</li>\n<li>Most Potent In second-generation sulfonylureas.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gliclazide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Considered safer regarding hypoglycemia,</li>\n<li>Antioxidative properties may improve <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> outcomes.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CuVdm7LRqNEU56h40ndn1749309889.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 27 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 65-year-old male with a history of Type 2 diabetes mellitus and chronic kidney disease (CKD) stage 4. He is currently on oral hypoglycemic agents, but his glycemic control has been suboptimal. His endocrinologist decides to start him on insulin therapy.Which of the following precautions is most important to consider before initiating insulin therapy in this patient?", "options": [{"label": "A", "text": "Assessing liver function tests (LFTs)", "correct": false}, {"label": "B", "text": "Evaluating renal function and adjusting the insulin dose accordingly", "correct": true}, {"label": "C", "text": "Monitoring for signs of diabetic ketoacidosis (DKA)", "correct": false}, {"label": "D", "text": "Assessing cardiac function to prevent hypoglycemia-related cardiac events", "correct": false}], "correct_answer": "B. Evaluating renal function and adjusting the insulin dose accordingly", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the different types of insulin with their respective onset and duration. Types of Insulin Onset and Duration 1. Insulin aspart A. Onset: 1-2 hours, Duration: 24 hours or more 2. Regular insulin B. Onset: 15-30 minutes, Duration: 3-5 hours 3. NPH C. Onset: 30-60 minutes, Duration: 5-8 hours 4. Insulin detemir D. Onset: 1-2 hours, Duration: 12-18 hours", "options": [{"label": "A", "text": "1 - B, 2 - D, 3 - C, 4 - A", "correct": false}, {"label": "B", "text": "1 - C, 2 - B, 3 - A, 4 - D", "correct": false}, {"label": "C", "text": "1 - B, 2 - C, 3 - D, 4 - A", "correct": true}, {"label": "D", "text": "1 - A, 2 - B, 3 - C, 4 - D", "correct": false}], "correct_answer": "C. 1 - B, 2 - C, 3 - D, 4 - A", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/cen8QOBqwWuHPhCCdh3a1724148730.jpeg"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types of Insulin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset and Duration</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> aspart</p>\n<p>(Rapid acting insulin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>B. Onset: 15-30 minutes, Duration: 3-5 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Regular insulin</p>\n<p>(Short acting insulin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C. Onset: 30-60 minutes, Duration: 5-8 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. NPH</p>\n<p>(Intermediate acting insulin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D. Onset: 1-2 hours, Duration: 12-18 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4. <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> detemir</p>\n<p>(Long acting insulin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A. Onset: 1-2 hours, Duration: 24 hours or more</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:654px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Preparation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Peak (hr)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Duration (hr)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Can be mixed with</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p><strong>Rapid (ultra-short) acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin lispro</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Clear</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>20-30 (mins)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-1.5</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>3-5</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Regular, NPH</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin aspart</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>20-30 (mins)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-1.5</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>3-5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin glulisine</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>20-40 (mins)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-2</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>3-5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Short acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Regular (soluble) insulin</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Clear</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30-60 (mins)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>2-3</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>6-8</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>All preparations (except <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> glargine/detemir)</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p><strong>Intermediate acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin <span class=\"customMeta\" data-dictid=\"39ecb6e07416927772029550b7e74a\">zinc</span> <span class=\"customMeta\" data-dictid=\"88f2ec11091692777199acf9e832c4\">suspension</span> or Lente</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Cloudy</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-2 (hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>8-10</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>12-20</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Regular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Neutral <span class=\"customMeta\" data-dictid=\"70c29bb1c31692777196ec6da543d4\">Protamine</span> Hagedorn (NPH) or isophane insulin</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>1-2 (hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>8-10</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>12-20</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p><strong>Long acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin glargine</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> \n\t\t\t<p>Clear</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>2-4 (hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>24</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Cannot mix with<br/>\n\t\t\tother insulins</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin detemir</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-4 (hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>20-24</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Ultra-long acting</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin degludec</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Clear</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>1-9 (hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>42</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Cannot mix with<br/>\n\t\t\tother insulins</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about the use of an insulin pump (continuous subcutaneous insulin infusion or CSII) is correct?", "options": [{"label": "A", "text": "Uses long-acting insulins to provide a constant basal infusion", "correct": false}, {"label": "B", "text": "Delivers insulin into the portal circulation", "correct": false}, {"label": "C", "text": "Uses only short-acting insulins", "correct": true}, {"label": "D", "text": "Not recommended in pronounced dawn phenomenon", "correct": false}], "correct_answer": "C. Uses only short-acting insulins", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/RSTl82oMyESBht2RTnLM1724149037.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:910px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Route of Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Insulin Formulation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Advantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Disadvantages</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Subcutaneous (SC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Short-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> (regular, lispro, aspart, glulisine)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Long-term treatment of diabetes, <span class=\"customMeta\" data-dictid=\"a3ec06b3241692777196c3f58fb999\">prandial</span> <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> control</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Mimics <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> release (analogues only), can be combined with long-acting insulins for basal-bolus regimen, lower risk of late <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> (analogues only)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Requires multiple daily injections for <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> control (especially regular insulin), <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> can be affected by several factors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Intermediate-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> (NPH)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Basal <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> coverage</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Less expensive than long-acting analogues</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Requires twice daily dosing, inconsistent absorption</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Long-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> (glargine, detemir, degludec)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Basal <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> coverage, <span class=\"customMeta\" data-dictid=\"67f123756d16927772026c46b8d27e\">fasting</span> <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> control</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Once daily injection, smoother time-action profile (detemir, degludec), lower risk of <span class=\"customMeta\" data-dictid=\"d51601f2c41692777193ddfa55d163\">nocturnal</span> <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> (glargine, degludec), can be combined with short-acting insulins for basal-bolus regimen</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Does not control mealtime glycemia, must be <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> separately from other insulins (glargine)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Intravenous (IV)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Short-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> (regular)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>DKA, <span class=\"customMeta\" data-dictid=\"c52b35ebb01692777189131c97fbba\">hyperglycemia</span> in hospitalised patients, situations where <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> requirements change rapidly</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Rapid <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> of <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> abnormalities (DKA &amp; hyperkalemia)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Long-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> should not be administered intravenously</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Insulin Pump (Continuous <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">Subcutaneous</span> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Infusion)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Short-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> (regular, analogues)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Provides both <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> and <span class=\"customMeta\" data-dictid=\"a3ec06b3241692777196c3f58fb999\">prandial</span> insulin</p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>More <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> replacement than injections, can adjust <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> rates for different times of day, can program boluses for meals, and can improve <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> control during exercise.</p>\n<p>Recommended in <strong>pronounced Dawn phenomenon</strong>. </p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Requires more patient responsibility than injections, risk of pump failure, cost, and <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> site infections.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the different types of insulin with their respective characteristics. Types of Insulin Characteristics 1. Insulin Lispro A. Proline at B28 replaced with aspartic acid 2. Insulin Aspart B. Glutamic acid at B29 and lysine at B3 3. Insulin Glulisine C. Complexed with zinc and protamine 4. NPH insulin D. Positions B28 and B29 modified", "options": [{"label": "A", "text": "1 - D, 2 - A, 3 - B, 4 - C", "correct": true}, {"label": "B", "text": "1 - B, 2 - D, 3 - A, 4 - C", "correct": false}, {"label": "C", "text": "1 - A, 2 - C, 3 - D, 4 - B", "correct": false}, {"label": "D", "text": "1 - C, 2 - D, 3 - B, 4 - A", "correct": false}], "correct_answer": "A. 1 - D, 2 - A, 3 - B, 4 - C", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/l1oAKrkCw06G3hWym4mu1724149161.jpeg"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Insulin Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Chain Difference from Human Insulin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Rapid-acting insulin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin Lispro</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Proline at B28 and <span class=\"customMeta\" data-dictid=\"6413333d09169277719125b8a2a652\">lysine</span> at B29 are reversed</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin Aspart</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Aspartic acid replaces <span class=\"customMeta\" data-dictid=\"e17970718c16927771967aa6347980\">proline</span> at B28</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin Glulisine</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Lysine replaces <span class=\"customMeta\" data-dictid=\"28ca653d321692777182331559c308\">asparagine</span> at B23; <span class=\"customMeta\" data-dictid=\"acfb68e3341692777188dea4dcdb1b\">glutamic acid</span> replaces <span class=\"customMeta\" data-dictid=\"6413333d09169277719125b8a2a652\">lysine</span> at B29</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Regular insulin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>No difference (also called human <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> insulin)</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Why is zinc used in the preparation of regular insulin?", "options": [{"label": "A", "text": "To stabilise insulin by maintaining a neutral pH solution", "correct": false}, {"label": "B", "text": "Forms complexes with insulin, allowing the gradual release of insulin monomers", "correct": true}, {"label": "C", "text": "Promotes rapid absorption of insulin after subcutaneous injection", "correct": false}, {"label": "D", "text": "Prevents insulin degradation in the bloodstream", "correct": false}], "correct_answer": "B. Forms complexes with insulin, allowing the gradual release of insulin monomers", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>PROPERTY</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>REGULAR INSULIN</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Clear solution</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Onset of action </strong>(subcutaneous)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>30-45 minutes, 0.5-1 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Peak effect </strong>(subcutaneous)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>2-3 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Effective duration </strong>(subcutaneous)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>6-8 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Compatibility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Can be mixed with all preparations <em>except</em> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> glargine and <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> detemir</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Synthesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Regular <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> is unmodified insulin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Route of administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Subcutaneous or intravenous</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Type 1 and <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes; control <span class=\"customMeta\" data-dictid=\"a3ec06b3241692777196c3f58fb999\">prandial</span> rise in blood glucose; <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> of hyperglycemia; <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> for <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"27b295ed331692777190e5e04eaa18\">ketoacidosis</span> and <span class=\"customMeta\" data-dictid=\"c52b35ebb01692777189131c97fbba\">hyperglycemia</span> in hospitalised patients</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 54-year-old male with type 2 diabetes mellitus is currently managed on metformin and gliclazide. However, his diabetes is not well-controlled, and he requires insulin therapy. He has a busy work schedule and prefers a regimen that minimises the number of daily injections. Which of the following insulin regimens would be most appropriate for this patient?", "options": [{"label": "A", "text": "Insulin glargine once daily in the evening and Lispro three times before major meals", "correct": false}, {"label": "B", "text": "A premixed combination of regular and NPH insulin twice daily", "correct": true}, {"label": "C", "text": "Insulin Aspart injected before each meal", "correct": false}, {"label": "D", "text": "CSII with regular insulin using an insulin pump", "correct": false}], "correct_answer": "B. A premixed combination of regular and NPH insulin twice daily", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:742px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p style=\"text-align:center\"><strong>PROPERTY</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p style=\"text-align:center\"><strong>INTERMEDIATE-ACTING INSULIN</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Specific preparation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>Insulin <span class=\"customMeta\" data-dictid=\"39ecb6e07416927772029550b7e74a\">zinc</span> <span class=\"customMeta\" data-dictid=\"88f2ec11091692777199acf9e832c4\">suspension</span> (Lente insulin), Neutral <span class=\"customMeta\" data-dictid=\"70c29bb1c31692777196ec6da543d4\">protamine</span> Hagedorn (NPH) insulin, or isophane insulin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>Cloudy solution</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Onset of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>1-2 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Peak effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>8-10 hours</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Effective duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>12-20 hours (Lente), 12-20 hours (NPH)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Compatibility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>Can be mixed with regular insulin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Disadvantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>The time course of <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> and intensity of action are relatively inconsistent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Major adverse effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>Hypoglycemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p><strong>Additional Information</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #222222; border-left:1px solid #222222; border-right:1px solid #222222; border-top:1px solid #222222; vertical-align:top\">\n<p>Intermediate-acting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> is formulated to prolong <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> absorption.</p>\n<p>It is often combined with regular <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> in a split-mixed regimen, subcutaneously twice daily, before breakfast and dinner.</p>\n<p>Lente - <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> <span class=\"customMeta\" data-dictid=\"39ecb6e07416927772029550b7e74a\">zinc</span> suspension.</p>\n<p>NPH <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> is formulated by adding <span class=\"customMeta\" data-dictid=\"70c29bb1c31692777196ec6da543d4\">protamine</span> to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> in a quantity just sufficient to complex all the <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> molecules at a neutral pH.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/USICYlXqi1ei1AhmJWGU1748805397.mp3", "video": ""}, {"text": "A 45-year-old man with a 10-year history of type 2 diabetes mellitus presents to the clinic for a follow-up appointment. He is currently on metformin and glipizide but has not achieved adequate glycemic control. His HbA1c is 8.2%, and he experiences frequent episodes of postprandial hyperglycemia. The physician decides to initiate a basal-bolus insulin regimen. Which of the following insulin regimens would be most appropriate for this patient?", "options": [{"label": "A", "text": "Insulin glargine at bedtime and insulin lispro before meals.", "correct": true}, {"label": "B", "text": "Insulin detemir twice daily and insulin aspart before meals.", "correct": false}, {"label": "C", "text": "Insulin degludec once daily and regular insulin before meals.", "correct": false}, {"label": "D", "text": "NPH insulin twice daily and insulin glulisine before meals.", "correct": false}], "correct_answer": "A. Insulin glargine at bedtime and insulin lispro before meals.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:790px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type of Insulin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Name of Insulin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Properties</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Long-acting</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Glargine (Lantus)</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>12-24 hrs</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Clear solution with a pH of 4.0 that stabilises the <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> hexamer; when <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> into the neutral pH of the <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> space, <span class=\"customMeta\" data-dictid=\"a00e90be0416927771803afbbf099b\">aggregation</span> occurs, resulting in prolonged, predictable <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> from the <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> site</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Detemir</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>6-10 hrs</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Modified by the addition of a <span class=\"customMeta\" data-dictid=\"bd2ac838bb16927771983dd9afc74c\">saturated</span> <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid to the ε <span class=\"customMeta\" data-dictid=\"543f207eb51692777181723491a358\">amino</span> group of LysB29, yielding myristoylated <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> that binds to <span class=\"customMeta\" data-dictid=\"1fa594dc2b169277718104d76aa4e2\">albumin</span> via its <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid chain when <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> subcutaneously</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Ultra-long acting</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Degludec</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>&gt;24 hrs</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Forms <span class=\"customMeta\" data-dictid=\"2547afae081692777193d9aadaef22\">multi</span> hexamers after <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> subcutaneously and is associated with less severe <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> than glargine</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 54-year-old woman with type 2 diabetes mellitus presents to the clinic for a routine check-up. She has been managing her diabetes with a combination of diet, exercise, and insulin injections for the past 10 years. During the physical examination, the physician notes an area of subcutaneous fat atrophy at the site where the patient frequently administers her insulin injections. Which of the following is this finding most likely attributed to?", "options": [{"label": "A", "text": "Allergic reaction to insulin", "correct": false}, {"label": "B", "text": "Lipoatrophy caused by older insulin preparations", "correct": true}, {"label": "C", "text": "Lipohypertrophy caused by the lipogenic action of insulin", "correct": false}, {"label": "D", "text": "Somogyi effect", "correct": false}], "correct_answer": "B. Lipoatrophy caused by older insulin preparations", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:810px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>ADVERSE EFFECT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>DESCRIPTION</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Hypoglycemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>The most frequent and serious reaction to <span class=\"customMeta\" data-dictid=\"18a9d4c52716927771878ee08e63ee\">exogenous</span> insulin, especially in <span class=\"customMeta\" data-dictid=\"ccff55377d16927771919dd7f8a964\">labile</span> diabetes.</p>\n<p>Symptoms: Sweating, anxiety, palpitations, tremors (sympathetic stimulation);<br/>\n\t\t\tdizziness, headache, and behavioural changes (glucose deprivation).</p>\n<p>Severe cases: mental confusion, seizures, <span class=\"customMeta\" data-dictid=\"e39842f67b1692777184171cd1852a\">coma</span> (blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> &lt; 40 mg/dL).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Local Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Swelling, erythema, and stinging, especially initially, at the <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> site</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Lipodystrophy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Rare; changes to <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> fat at <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> site, more common with older insulin. Caused by repetitive injections at the same site. Prevent by changing <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> sites regularly.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Allergy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Very rare with human/purified insulins. Caused by contaminating proteins.</p>\n<p>Symptoms: Urticaria, angioedema, anaphylaxis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Hypokalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Insulin moves <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> from the <span class=\"customMeta\" data-dictid=\"a813884d6016927771838d2d1f9d1d\">bloodstream</span> into cells, leading to low blood <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Edema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Short-lived <span class=\"customMeta\" data-dictid=\"87d66686131692777186580bbbee76\">dependent edema</span> due to sodium <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> may occur when starting <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Weight Gain</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Modest weight gain with <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> treatment for <span class=\"customMeta\" data-dictid=\"ebcb7136251692777201ef4b5c5718\">type 1</span> and <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 24-year-old male with a history of type 1 diabetes presents to the emergency department with symptoms of polyuria, polydipsia, nausea, vomiting, and abdominal pain. His blood glucose level is 450 mg/dL, arterial blood pH is 7.1, and serum bicarbonate is 12 mEq/L. Urine analysis shows high levels of ketones. He is diagnosed with diabetic ketoacidosis (DKA). Which of the following is the most appropriate initial insulin therapy for this patient?", "options": [{"label": "A", "text": "Subcutaneous injection of regular insulin", "correct": false}, {"label": "B", "text": "Intravenous infusion of regular insulin", "correct": true}, {"label": "C", "text": "Subcutaneous injection of insulin glargine", "correct": false}, {"label": "D", "text": "Intravenous infusion of insulin glargine.", "correct": false}], "correct_answer": "B. Intravenous infusion of regular insulin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:711px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Insulin Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Rationale</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>DKA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Intravenous (IV) regular <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> is used to correct <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> abnormalities rapidly.</p>\n<p><strong>Initial dose:</strong> <span class=\"customMeta\" data-dictid=\"8d138d554c16927771835be732558c\">Bolus</span> of 0.1-0.2 U/kg, followed by a continuous <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> of 0.1 U/kg/hour.</p>\n<p><strong>Adjustment: </strong>Double the <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> rate if no significant decrease in blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> after 2 hours.</p>\n<p><strong>Maintenance:</strong> Once blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> reaches 300 mg/dL, reduce the <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> rate to 2-3 U/hour until consciousness is regained.</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Regular insulin, the only type used for IV injections, promptly reverses the <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> consequences of <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> deficiency.</p>\n<p>This method ensures a rapid blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> reduction, allows <span class=\"customMeta\" data-dictid=\"3562d699c516927771909a426ea8ef\">infusion</span> rate adjustments based on patient response, and prevents <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> while providing ongoing <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> support.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Hyperkalemia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Regular <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> IV is administered along with 50% dextrose</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>This approach helps shift <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> back into cells, <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>HHS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>IV Regular <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> is preferred.</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>The general principles of treatment are the same as for ketoacidotic coma, except that faster fluid replacement is to be instituted.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding Technosphere insulin (Afrezza), an inhaled insulin, is NOT TRUE?", "options": [{"label": "A", "text": "Absorbed from alveoli when administered using a breath-powered inhaler", "correct": false}, {"label": "B", "text": "TI is a new dry powder formulation of recombinant human insulin", "correct": false}, {"label": "C", "text": "Used to manage blood sugar after meals", "correct": false}, {"label": "D", "text": "Typically used alone without additional insulin", "correct": true}], "correct_answer": "D. Typically used alone without additional insulin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:667px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Nasal <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Delivery</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Information</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Formulation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Dry powder <strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Device</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Breath-powered inhaler <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Absorption</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Via alveoli <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Onset of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Rapid (within 10-15 minutes)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Short (nearly 3 hours) ➜ Used before meal to control <span class=\"customMeta\" data-dictid=\"a3ec06b3241692777196c3f58fb999\">prandial</span> sugar levels <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Additional Information</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Typically used with long-acting <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> injections <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Efficacy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Comparable to <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> analogs</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Weight Gain and</strong></p>\n<p><strong>Hypoglycemia Risk</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Potentially less than <span class=\"customMeta\" data-dictid=\"6a367ebd0c169277719091155a5b0f\">injected</span> insulin</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Common Side Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Cough (&gt; 25% of patients), may cause lung cancer (rare)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p>Smokers and patients with COPD</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following medications is most suitable for treating cryptorchidism (undescended testes)?", "options": [{"label": "A", "text": "Pulsatile GnRH", "correct": true}, {"label": "B", "text": "Non-pulsatile GnRH", "correct": false}, {"label": "C", "text": "Testosterone", "correct": false}, {"label": "D", "text": "Estrogen", "correct": false}], "correct_answer": "A. Pulsatile GnRH", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"a2af1612021692777196c7044ee75b\"&gt;Pulsatile&lt;/span&gt; GnRH\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True statement regarding the administration of 5 alpha - reductase inhibitor is / are : Reduces dihydrotestosterone levels Reduces testosterone levels Elevates PSA levels Decreases PSA levels", "options": [{"label": "A", "text": "1,2,3", "correct": false}, {"label": "B", "text": "1,3,4", "correct": false}, {"label": "C", "text": "1,4", "correct": true}, {"label": "D", "text": "2,3", "correct": false}], "correct_answer": "C. 1,4", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Property</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-alpha <span class=\"customMeta\" data-dictid=\"6afb2667fe16927771975a8db1378b\">reductase</span> inhibitors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> <strong>type 2 5-alpha reductase,</strong> which converts <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> to <span class=\"customMeta\" data-dictid=\"1342b78d4116927771866d41cb1f62\">dihydrotestosterone</span> (DHT)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Therapeutic uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> prostatic <span class=\"customMeta\" data-dictid=\"4c5d5ef6c31692777189820d4b320d\">hyperplasia</span> (BPH) and male pattern baldness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dosage forms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral <span class=\"customMeta\" data-dictid=\"508e14a7ca16927772002140ece8fb\">tablet</span> and <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> solution</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacokinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absorbed well orally; undergoes extensive <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> via CYP3A4 enzyme; eliminated via <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> and feces</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersensitivity to finasteride, pregnancy, breastfeeding</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Impotence, decreased libido, <span class=\"customMeta\" data-dictid=\"9ee9011df41692777187bfb1eea894\">ejaculation</span> disorders, <span class=\"customMeta\" data-dictid=\"78cd34126d16927771887bf6b44cf6\">gynecomastia</span> and tenderness, allergic reactions.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following anti-diabetic drugs is associated with the increased risk of fractures?", "options": [{"label": "A", "text": "Rosiglitazone", "correct": true}, {"label": "B", "text": "Liraglutide", "correct": false}, {"label": "C", "text": "Voglibose", "correct": false}, {"label": "D", "text": "Metformin", "correct": false}], "correct_answer": "A. Rosiglitazone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who is on treatment for hyperlipidemia develops gallstones. What is the mechanism of action of the causative drug that was given to this patient?", "options": [{"label": "A", "text": "Inhibitis HMG CoA reductase", "correct": false}, {"label": "B", "text": "Activates PPAR alpha", "correct": true}, {"label": "C", "text": "Blinds to deoxycholic acid", "correct": false}, {"label": "D", "text": "Decrease VLDL", "correct": false}], "correct_answer": "B. Activates PPAR alpha", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The half life of letrozole is:", "options": [{"label": "A", "text": "46 hours", "correct": true}, {"label": "B", "text": "70 hours", "correct": false}, {"label": "C", "text": "90 hours", "correct": false}, {"label": "D", "text": "120 hours", "correct": false}], "correct_answer": "A. 46 hours", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Letrozole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aromatase inhibitor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inhibition of <span class=\"customMeta\" data-dictid=\"b249ba1c6a16927771821b83b1fd9b\">Aromatase</span> Enzyme</strong><strong> </strong></p>\n<p>↓</p>\n<p>Reduction in <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Synthesis</p>\n<p>↓</p>\n<p>Decreased <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> Levels in circulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Breast cancer treatment</li>\n<li>Ovulation induction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hot flashes, joint pain, bone loss, headache, vomiting, nausea</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old obese lady with diabetes, managed with oral hypoglycemic agents, now presents to the casualty with a hypoglycemic episode. Which of the following drugs is most likely responsible for her hypoglycemic episode?", "options": [{"label": "A", "text": "Metformin", "correct": false}, {"label": "B", "text": "Pioglitazone", "correct": false}, {"label": "C", "text": "Sitagliptin", "correct": false}, {"label": "D", "text": "Glimepiride", "correct": true}], "correct_answer": "D. Glimepiride", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/IY2K2D6ylFhToCCDEEPD1745842217.png"], "explanation": "<p>Correct Answer D - Glimepiride</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sulfonylureas</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Generation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Special Points</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>First Generation</strong></p>\n<ul>\n<li>Higher risk of hypoglycemia</li>\n<li>Less commonly used</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tolbutamide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Short-acting</li>\n<li>Lower potency</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Chlorpropamide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Long-acting</li>\n<li>Antidiuretic effects.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Tolazamide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intermediate duration</li>\n<li>More potent.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Second Generation</strong></p>\n<ul>\n<li>More potent than first-generation drugs</li>\n</ul>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glibenclamide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>longer duration</li>\n<li>There is a higher risk of <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> compared to other second-generation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glipizide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Shorter half-life</li>\n<li>Lower risk of hypoglycemia</li>\n<li>Preferable in elderly patients or those with <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glimepiride</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Once-daily dosing,</li>\n<li>Lower risk of hypoglycemia</li>\n<li>Most Potent In second-generation sulfonylureas.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Gliclazide</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Considered safer regarding hypoglycemia,</li>\n<li>Antioxidative properties may improve <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> outcomes.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 66-year-old male presents with urinary difficulties, back pain, an elevated PSA blood test, two radiolucent lesions in the bony pelvis on X-ray, and enlarged lymph nodes in the lower abdomen on MRI. What medication is most appropriate for treating his condition?", "options": [{"label": "A", "text": "Anastrozole", "correct": false}, {"label": "B", "text": "Desogestrel", "correct": false}, {"label": "C", "text": "Goserelin", "correct": true}, {"label": "D", "text": "Oxandrolone", "correct": false}], "correct_answer": "C. Goserelin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Goserelin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>GnRH antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>GnRH <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">GnRH antagonist</p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\"><strong>Blocks the GnRH <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> in the pituitary</strong></p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\">Decreased <span class=\"customMeta\" data-dictid=\"02315055441692777203a721dd9b19\">FSH</span> and LH levels</p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\">Decreased <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">Estrogen</span> and Progesterone</p>\n<p> </p>\n<ul>\n<li>They have a lower risk of ovarian hyperstimulation.</li>\n<li>They offer complete <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> gonadotropins.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">GnRH agonist</p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\">Initial <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> of <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> release</p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\"><strong>Downregulation of GnRH receptors</strong></p>\n<p style=\"text-align: center;\">↓</p>\n<p style=\"text-align: center;\">Suppression of <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> release</p>\n<p> </p>\n<ul>\n<li>Recovery occurs after 2-3 months of the stoppage of medication.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid white; border-top:none; vertical-align:top\">\n<ul>\n<li>Cetrorelix</li>\n<li>Ganirelix</li>\n<li>Degarelix</li>\n<li>Abarelix</li>\n<li>Elagolix</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Leuprolide<strong> </strong></li>\n<li>Goserelin<strong> </strong></li>\n<li>Histrelin</li>\n<li>Buserelin</li>\n<li>Triptorelin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prostate cancer.</li>\n<li>Endometriosis.</li>\n<li>In Vitro <span class=\"customMeta\" data-dictid=\"2a8e411e2116927772022dd4b365bc\">Fertilization</span> (Suppression of <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">Gonadotropin</span> before administration of <span class=\"customMeta\" data-dictid=\"18a9d4c52716927771878ee08e63ee\">exogenous</span> hormones).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Delayed puberty</li>\n<li>Precocious puberty</li>\n<li>Anovulation</li>\n<li>Endometriosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Intermittent injection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Continuous injection</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>This is used when increased <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> is needed. As an agonist, its initial action <strong>stimulates the GnRH receptors</strong>, resulting in the release of gonadotropins.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>This is preferred when decreased levels of gonadotropins or sex hormones are needed. Continuous <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> results in a <strong>negative feedback mechanism</strong> on the receptors, leading to their <strong>downregulation</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>DOC in Delayed puberty.</li>\n<li>Azoospermia (Male Infertility).</li>\n<li>Anovulation (Female Infertility).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>DOC in <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">Prostate</span> carcinoma.</li>\n<li>DOC in<strong> <span class=\"customMeta\" data-dictid=\"58aedbfaa916927771960c11064ef0\">Precocious</span> puberty.</strong></li>\n<li>Endometriosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increased size of the <span class=\"customMeta\" data-dictid=\"7b1a7ff355169277719401475de6fb\">ovary</span> may lead to pain in the abdomen.</li>\n<li>Rupture of the ovary: Hemoperitoneum.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Postmenopausal symptoms include hot flashes, <span class=\"customMeta\" data-dictid=\"4c8be6d6b716927771948551f98378\">Osteoporosis</span> and Depression.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications can lead to the development of gynecomastia?", "options": [{"label": "A", "text": "Tamoxifen", "correct": false}, {"label": "B", "text": "Oxytocin", "correct": false}, {"label": "C", "text": "Spironolactone", "correct": true}, {"label": "D", "text": "Clomiphene citrate", "correct": false}], "correct_answer": "C. Spironolactone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications does not require dosage adjustment for individuals with chronic kidney disease?", "options": [{"label": "A", "text": "Linagliptin", "correct": true}, {"label": "B", "text": "Saxagliptin", "correct": false}, {"label": "C", "text": "Repaglinide", "correct": false}, {"label": "D", "text": "Glyburide", "correct": false}], "correct_answer": "A. Linagliptin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Linagliptin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Increase <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">Incretin</span> Levels</strong>: Prevents <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">degradation</span> of <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">incretin</span> hormones (GLP-1 and GIP)</li>\n<li><strong>Enhance <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Secretion</strong> from the <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> in response to meals. (no risk of hypoglycemia)</li>\n<li><strong>Reduce <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</strong></li>\n<li>Maintain neutral weight</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> drug (type-2 diabetes)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Linagliptin</strong>: <strong>Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</strong></li>\n<li>Teneligliptin: Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Vildagliptin: Hepatotoxic</li>\n<li>Alogliptin</li>\n<li>Sitagliptin</li>\n<li>Saxagliptin:\n\t\t\t\t<ul>\n<li>Metabolised by CYP3A4, it has more drug interactions.</li>\n<li>Requires dose adjustment in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment.</li>\n<li>Risk of congestive heart failure.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li><strong>Pancreatitis</strong> (lesser than GLP-1)</li>\n<li>Risk of pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer (lesser than GLP-1)</li>\n<li>Arthritis, Nasopharyngitis:\n\t\t\t\t<ul>\n<li>Increase interleukins and cytokines levels (similar structure to CD26)</li>\n</ul>\n</li>\n<li>Hypersensitivity reactions: Steven-Johnson syndrome, angioedema</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which PDE-5 inhibitor has the longest duration of action among the options provided?", "options": [{"label": "A", "text": "Sildenafil", "correct": false}, {"label": "B", "text": "Tadalafil", "correct": true}, {"label": "C", "text": "Vardenafil", "correct": false}, {"label": "D", "text": "Avanafil", "correct": false}], "correct_answer": "B. Tadalafil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - T\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For the treatment of thyroid cancer, which radioactive iodine isotope among the options listed below is used?", "options": [{"label": "A", "text": "Iodine -125", "correct": false}, {"label": "B", "text": "Iodine-131", "correct": true}, {"label": "C", "text": "Iodine-127", "correct": false}, {"label": "D", "text": "Iodine-123", "correct": false}], "correct_answer": "B. Iodine-131", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Iodine-13\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 66-year-old man with a history of chronic kidney disease presents with poorly controlled diabetes mellitus. You are considering adjusting his diabetes medication regimen to improve glycemic control. Which of the following needs no dose modification in this patient?", "options": [{"label": "A", "text": "Repaglinide", "correct": false}, {"label": "B", "text": "Linagliptin", "correct": true}, {"label": "C", "text": "Glyburide", "correct": false}, {"label": "D", "text": "Saxagliptin", "correct": false}], "correct_answer": "B. Linagliptin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Dipeptidyl peptidase-4 (DPP-4) inhibitors:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Increase <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">Incretin</span> Levels</strong>: Prevents <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">degradation</span> of <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">incretin</span> hormones (GLP-1 and GIP)</li>\n<li><strong>Enhance Insulin Secretion</strong> from the <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> in response to meals. (no risk of hypoglycemia)</li>\n<li><strong>Reduce <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">glucagon</span> secretion</strong></li>\n<li>Maintain neutral weight</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> drug (type-2 diabetes)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Linagliptin: Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Teneligliptin: Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Vildagliptin: Hepatotoxic</li>\n<li>Alogliptin</li>\n<li>Sitagliptin</li>\n<li>Saxagliptin: <strong>(Option D)</strong>\n<ul>\n<li>Metabolised by <strong>CYP3A4</strong>, it has more drug interactions.</li>\n<li>Requires dose adjustment in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> due to partial <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> excretion.</li>\n<li>Risk of congestive heart failure.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li><strong>Pancreatitis</strong> (lesser than GLP-1)</li>\n<li>Risk of pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer (lesser than GLP-1)</li>\n<li>Arthritis, Nasopharyngitis:\n\t\t\t\t<ul>\n<li>Increase interleukins and cytokines levels (similar structure to CD26)</li>\n</ul>\n</li>\n<li>Hypersensitivity reactions: Steven-Johnson syndrome, angioedema</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding Clomiphene citrate is incorrect?", "options": [{"label": "A", "text": "Causes mono follicular development", "correct": true}, {"label": "B", "text": "Inhibits negative feedback on GnRH", "correct": false}, {"label": "C", "text": "Causes endometrial thinning", "correct": false}, {"label": "D", "text": "Can be used with Gonadotropin", "correct": false}], "correct_answer": "A. Causes mono follicular development", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>Clomiphene citrate</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p>It is an unequal mixture of two isomers, Zuculomiphene + Eclomiphen.e</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Zuclomiphene</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>The weaker isomer with partial <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> activity.</li>\n<li>Non-steroidal compound that blocks the negative <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> feedback of estrogens on the <span class=\"customMeta\" data-dictid=\"32b8d1e25c1692777189a123d50ec1\">hypothalamus</span> (GnRH release) (Option B)</li>\n<li>Results in sthe urge of gonadotropin, which stimulates ovulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Enclomiphene</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>The stronger isomer has predominant <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> activity.</li>\n<li>Primarily responsible for the anti-estrogenic effects that stimulate <span class=\"customMeta\" data-dictid=\"514d28a1c21692777188703b64cfde\">gonadotropin</span> release and induce ovulation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Action</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Thickening of <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> mucus</li>\n<li>Thinning of the endometrium (Option C)</li>\n<li>Multiple <span class=\"customMeta\" data-dictid=\"031a38f17a16927772036476ede2ae\">follicular</span> development</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Uses</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Infertility due to absent/irregular <span class=\"customMeta\" data-dictid=\"264a9eb50d1692777194427a13247b\">ovulation</span> due to hypothalamic-pituitary <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> associated with normal levels of <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> estradiol.</li>\n<li>It can be used along with <span class=\"customMeta\" data-dictid=\"18a9d4c52716927771878ee08e63ee\">exogenous</span> Gonadotropin (Option D)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Side effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Hot flushes and nausea</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following can be given for the long-term management of obesity?", "options": [{"label": "A", "text": "Liraglutide", "correct": true}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Sibutramine", "correct": false}, {"label": "D", "text": "Fenfluramine", "correct": false}], "correct_answer": "A. Liraglutide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Liraglutide</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>GLP-1 (glucagon-like peptide-1) analogues</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Enhance <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in response to food intake, which helps manage <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> levels. (No <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> risk)</li>\n<li>Suppress <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</li>\n<li>Slow <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">Gastric</span> <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">Emptying</span> leads to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> food intake.</li>\n<li>Promote <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">satiety</span> and help with weight loss.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Type-2 diabetes mellitus</li>\n<li>Anti-obesity drug: <span class=\"customMeta\" data-dictid=\"5861d6a9c91692777191ad56ffae72\">Liraglutide</span> and Semaglutide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs: </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Injectables:</strong></p>\n<ol>\n<li>Exenatide: <strong>Shortest</strong> acting</li>\n<li>Lixisenatide: <strong>Albumin</strong> bound, longer acting</li>\n<li>Liraglutide</li>\n<li>Dulaglutide</li>\n<li>Albiglutide</li>\n</ol>\n<p><strong>Injectable and Oral Route:</strong></p>\n<ol>\n<li>Semaglutide: <strong>Longest-acting</strong></li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li>Gallstones</li>\n<li><strong>Pancreatitis</strong></li>\n<li>Risk of <strong>Pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer</strong> (medullary <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> of the thyroid): contraindicated in <strong>MEN syndrome </strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following can be given for the long-term management of obesity?", "options": [{"label": "A", "text": "Liraglutide", "correct": true}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Sibutramine", "correct": false}, {"label": "D", "text": "Fenfluramine", "correct": false}], "correct_answer": "A. Liraglutide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Liraglutide:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>GLP-1 (glucagon-like peptide-1) analogues</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Enhance <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in response to food intake, which helps manage <span class=\"customMeta\" data-dictid=\"5e98c7ac6916927771967b424f152e\">postprandial</span> blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> levels. (No <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> risk)</li>\n<li>Suppress <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</li>\n<li>Slow <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">Gastric</span> <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">Emptying</span> leads to <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> food intake.</li>\n<li>Promote <span class=\"customMeta\" data-dictid=\"2e2efa1007169277719844bd43f5aa\">satiety</span> and help with weight loss.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Type-2 diabetes mellitus</li>\n<li>Anti-obesity drug: <span class=\"customMeta\" data-dictid=\"5861d6a9c91692777191ad56ffae72\">Liraglutide</span> and Semaglutide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs: </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Injectables:</strong></p>\n<ol>\n<li>Exenatide: <strong>Shortest</strong> acting</li>\n<li>Lixisenatide: <strong>Albumin</strong> bound, longer acting</li>\n<li>Liraglutide</li>\n<li>Dulaglutide</li>\n<li>Albiglutide</li>\n</ol>\n<p><strong>Injectable and Oral Route:</strong></p>\n<ol>\n<li>Semaglutide: <strong>Longest-acting</strong></li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li>Gallstones</li>\n<li><strong>Pancreatitis</strong></li>\n<li>Risk of <strong>Pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer</strong> (medullary <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> of the thyroid): contraindicated in <strong>MEN syndrome </strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old postmenopausal female patient with a previous history of Colle’s fracture came to the OPD with complaints of lower backache. On evaluation, her T score was -2.5. Which of the following statements about the management of her condition are false?", "options": [{"label": "A", "text": "Teriparatide should be started before supplementing with bisphosphonates", "correct": false}, {"label": "B", "text": "Bisphosphonates are not given for more than a year", "correct": true}, {"label": "C", "text": "Calcium requirement is 1200 mg per day", "correct": false}, {"label": "D", "text": "Oral vitamin D3 is given along with oral calcium", "correct": false}], "correct_answer": "B. Bisphosphonates are not given for more than a year", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Am4TZ434WQ1WAjPfDjII1746448469.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Role of Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Osteoporosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Effective in preventing and treating <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> osteoporosis, age-related, idiopathic, and steroid-induced osteoporosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Paget's Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Arrest osteolytic lesions, reduce bone pain, and improve secondary symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypercalcemia of Malignancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lower <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels, especially in severe cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metastatic Bone Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Arrest osteolytic lesions and reduce bone pain.</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:633px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Pharmacological Agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bisphosphonates </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Interfere with <strong>osteoclast</strong> activity, leading to decreased bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Calcitonin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <strong>osteoclast</strong> activity, reducing bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Denosumab</strong> <strong> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It inhibits the RANK ligand, which is essential for <strong>osteoclast </strong>formation and function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Estrogen/Raloxifene</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit <strong>osteoclast</strong> activity and slow bone loss.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cinacalcet</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Indirectly reduces <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by <strong>lowering <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> levels</strong>.(by stimulating CaSR receptors)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Teriparatide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"b566321fe8169277719716b1cf4df0\">recombinant</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> stimulates <strong>osteoblast </strong>activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Strontium Ranelate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dual action:</strong> It promotes bone formation by stimulating <strong>osteoblasts </strong>and decreases <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by inhibiting <strong>osteoclast</strong> activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Calcium and vitamin D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It suppresses <span class=\"customMeta\" data-dictid=\"259c7d2f221692777183ec47febc61\">bone turnover</span> and improves bone mineral density</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In renal failure, which of the listed medications does not require dosage adjustment?", "options": [{"label": "A", "text": "Sitagliptin", "correct": false}, {"label": "B", "text": "Saxagliptin", "correct": false}, {"label": "C", "text": "Vildagliptin", "correct": false}, {"label": "D", "text": "Linagliptin", "correct": true}], "correct_answer": "D. Linagliptin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Linagliptin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Dipeptidyl peptidase-4 (DPP-4) inhibitors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Increase <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">Incretin</span> Levels</strong>: Prevents <span class=\"customMeta\" data-dictid=\"d395f610461692777185cbe8b8806d\">degradation</span> of <span class=\"customMeta\" data-dictid=\"148de0e6a61692777190372a1432f0\">incretin</span> hormones (GLP-1 and GIP)</li>\n<li><strong>Enhance <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Secretion</strong> from the <span class=\"customMeta\" data-dictid=\"2e2fe8c6c116927771946fb9a8adb0\">pancreas</span> in response to meals. (no risk of hypoglycemia)</li>\n<li><strong>Reduce <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">Glucagon</span> Secretion</strong></li>\n<li>Maintain neutral weight</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> drug (type-2 diabetes)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ol>\n<li><strong>Linagliptin</strong>: <strong>Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</strong></li>\n<li>Vildagliptin: Hepatotoxic</li>\n<li>Alogliptin</li>\n<li>Sitagliptin</li>\n<li>Saxagliptin <strong>(Option B):</strong>\n<ol>\n<li>Metabolised by CYP3A4, it has more drug interactions.</li>\n<li>Requires dose adjustment in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> impairment.</li>\n<li>Risk of congestive heart failure.</li>\n</ol>\n</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (most common)</li>\n<li><strong>Pancreatitis</strong> (lesser than GLP-1)</li>\n<li>Risk of pancreatic and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> cancer (lesser than GLP-1)</li>\n<li>Arthritis, Nasopharyngitis:\n\t\t\t\t<ul>\n<li>Increase interleukins and cytokines levels (similar structure to CD26)</li>\n</ul>\n</li>\n<li>Hypersensitivity reactions: Steven-Johnson syndrome, angioedema</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the listed medications aids in the stimulation of bone formation?", "options": [{"label": "A", "text": "Calcitonin", "correct": false}, {"label": "B", "text": "Raloxifene", "correct": false}, {"label": "C", "text": "Bisphosphonates", "correct": false}, {"label": "D", "text": "Teriparatide", "correct": true}], "correct_answer": "D. Teriparatide", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/7zZOV4YJ4qYlM3yqU9v31745822263.png"], "explanation": "<p>Correct Answer D - Teriparatide</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Pharmacological Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bisphosphonates </strong> <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Interfere with <strong>osteoclast</strong><strong> </strong>activity, leading to decreased bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Calcitonin</strong> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <strong>osteoclast</strong> activity, reducing bone resorption.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Denosumab</strong> <strong> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It inhibits the RANK ligand, which is essential for <strong>osteoclast </strong>formation and function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Estrogen/Raloxifene (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit <strong>osteoclast </strong>activity and slow bone loss.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cinacalcet</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Indirectly reduces <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by<strong> <span class=\"customMeta\" data-dictid=\"ff02aa40d51692777191246d4a9b87\">lowering</span> <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> levels</strong>. (by stimulating CaSR receptors)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Teriparatide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"b566321fe8169277719716b1cf4df0\">recombinant</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of <span class=\"customMeta\" data-dictid=\"5eff25235516927771968c590529d7\">PTH</span> stimulates <span class=\"customMeta\" data-dictid=\"8e55f8d71d1692777194a10c3d3d9d\">osteoblast</span> activity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Strontium Ranelate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dual action:</strong> It promotes bone formation by stimulating <strong>osteoblasts</strong> and decreases <span class=\"customMeta\" data-dictid=\"17d9369c3f1692777183b01f1dc72f\">bone resorption</span> by inhibiting <strong>osteoclast</strong> activity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is used in first-line management of post-menopausal osteoporosis?", "options": [{"label": "A", "text": "Estrogen", "correct": false}, {"label": "B", "text": "Bisphosphonate", "correct": true}, {"label": "C", "text": "Raloxifene", "correct": false}, {"label": "D", "text": "Combined oral contraception", "correct": false}], "correct_answer": "B. Bisphosphonate", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/eOQohY71h0ZAUBlVAx0E1746436515.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:165px\">\n<tbody>\n<tr>\n<td colspan=\"9\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1st generation</strong></p>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2nd generation</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3rd generation</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Etidronate</li>\n<li>Clodronate</li>\n</ul>\n</td>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Alendronate</li>\n<li>Risedronate</li>\n<li>Ibandronate</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Zoledronate</li>\n<li>Pamidronate</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td colspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of <span class=\"customMeta\" data-dictid=\"c21bdae5e116927771947204c2076c\">osteoclast</span> activity and bone resorption.</p>\n<p><img alt=\"PH184\" data-author=\"\" data-hash=\"11850\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/eOQohY71h0ZAUBlVAx0E1746436515.png\"/></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Frequency of Administration</strong></p>\n</td>\n<td colspan=\"6\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More potent drugs require less frequent administration</p>\n<ul>\n<li>Alendronate: Given once a week.</li>\n<li>Risedronate: Given once a week.</li>\n<li>Ibandronate: Given once a month.</li>\n<li>Zoledronate: Given once a year.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Uses of Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Role of Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Osteoporosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Effective in preventing and treating <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> osteoporosis, age-related, idiopathic, and steroid-induced osteoporosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Paget's Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Arrest osteolytic lesions, reduce bone pain, and improve secondary symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypercalcemia of Malignancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lower <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> levels, especially in severe cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metastatic Bone Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Arrest osteolytic lesions and reduce bone pain.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Adverse effects of Bisphosphonates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bisphosphonates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etidronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Interference with bone mineralisation, potential osteomalacia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pamidronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thrombophlebitis, bone pain, fever, leukopenia, flu-like symptoms.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alendronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Esophagitis, <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> erosion, <span class=\"customMeta\" data-dictid=\"db0b2c70cb1692777197d6e5e33d95\">retrosternal</span> pain, flatulence.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ibandronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Risk of flu-like symptoms with <span class=\"customMeta\" data-dictid=\"27b78a96071692777190f4dfb93430\">intravenous</span> infusion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Risedronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Generally well-tolerated, potential for <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> upset.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Zoledronate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Severe hypocalcemia, nephrotoxicity, flu-like symptoms, <span class=\"customMeta\" data-dictid=\"ffadabff021692777194c8ebe87262\">osteonecrosis</span> of the jaw.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Oral Bisphosphonates causes esophagitis: Should be administered on an empty stomach with plenty of distilled water. Patient should not eat anything and should not lie down for 30 minutes - To avoid <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> esophagitis.</li>\n<li>Bisphosphonates are associated with an increased risk of <span class=\"customMeta\" data-dictid=\"6aad7ac3ba16927771992f27501295\">Subtrochanteric</span> <span class=\"customMeta\" data-dictid=\"512283ec9816927772024c89478b7d\">femur</span> fracture.</li>\n<li>Bisphosphonates are C/I in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure.</li>\n<li>Regular <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> check-ups are advised to monitor for <span class=\"customMeta\" data-dictid=\"ffadabff021692777194c8ebe87262\">osteonecrosis</span> of the jaw.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the management of diabetes mellitus, lactic acidosis is caused by which of the following?", "options": [{"label": "A", "text": "Tolbutamide", "correct": false}, {"label": "B", "text": "Glipizide", "correct": false}, {"label": "C", "text": "Pioglitazone", "correct": false}, {"label": "D", "text": "Metformin", "correct": true}], "correct_answer": "D. Metformin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Metformin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Metformin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Stimulates the AMP-dependent protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> (AMPK</strong>) in the presence of insulin.</li>\n<li><strong>It inhibits <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> gluconeogenesis</strong>, <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid oxidation, and non-oxidative <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and <strong>increases <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> sensitivity.</strong></li>\n<li>Inhibits the <strong>mitochondrial <span class=\"customMeta\" data-dictid=\"124462cc291692777188e1a9cce583\">glycerol</span> <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> dehydrogenase</strong></li>\n<li>Reduces <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> resistance to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> in muscle and <span class=\"customMeta\" data-dictid=\"5c2a4a949d16927771802ba54640cc\">adipose</span> tissues</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dose </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>500 mg OD to 2550 mg/day (max)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>First-line oral <span class=\"customMeta\" data-dictid=\"6bffb538c616927771895e03011a28\">hypoglycemic</span> </strong>for the treatment of <span class=\"customMeta\" data-dictid=\"05e8c1df0d1692777201c9acee8b1f\">type 2</span> diabetes mellitus.</p>\n<p>DOC: <strong>Prophylaxis in</strong> <strong>prediabetes</strong> or impaired <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> tolerance</p>\n<p>Metabolic syndrome</p>\n<p>DOC: Diabetes due to <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> resistance</p>\n<ul>\n<li><strong>In PCOS:</strong> Metformin also promotes ovulation</li>\n<li><strong>Clozapine-induced DM/glucose intolerance</strong>.</li>\n<li>Cushing syndrome</li>\n<li><strong>Gestational diabetes</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Other benefits </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Weight loss in <span class=\"customMeta\" data-dictid=\"43663fecf11692777194c870d1d548\">obese</span> patients and weight <span class=\"customMeta\" data-dictid=\"da9ba55df01692777193ed69860f09\">neutrality</span> in thin patients.</li>\n<li>There is no risk of <span class=\"customMeta\" data-dictid=\"78c658d4ed1692777189098c7544b9\">hypoglycemia</span> (No effect during the normoglycemic state).</li>\n<li><strong>Reduction of <span class=\"customMeta\" data-dictid=\"e5607ecb0d1692777191a8a4ffa1b2\">lipogenesis</span> (decrease <span class=\"customMeta\" data-dictid=\"482f0bd5841692777200af07c2766c\">triglyceride</span> and LDL levels).</strong></li>\n<li><strong>Decreases micro- and <span class=\"customMeta\" data-dictid=\"c33e0939ff1692777191af7082a7ce\">macrovascular</span> complications of DM</strong>\n<ul>\n<li>Micro: <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> neuropathy, nephropathy, retinopathy</li>\n<li>Macro: MI and stroke</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea/Vomiting/Diarrhoea</li>\n<li>Megaloblastic anaemia: reduces vitamin B12 <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> from GIT</li>\n<li>Lactic acidosis</li>\n<li>Avoid metformin in Renal disorder, liver disease, COPD, CHF, dehydration, and <span class=\"customMeta\" data-dictid=\"fe9ab8afe416927771980091186846\">sepsis</span> (hypoxia increases <span class=\"customMeta\" data-dictid=\"b82539c9ae1692777191a3f7ddd7bb\">lactic</span> acid production).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Metformin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Activates AMP-dependent protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> (AMPK), inhibiting <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> <span class=\"customMeta\" data-dictid=\"724a9faafe1692777188ca8840ec5c\">gluconeogenesis</span> and <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acid <span class=\"customMeta\" data-dictid=\"224ea8a9e41692777194e81be113d8\">oxidation</span> while increasing <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">insulin</span> sensitivity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dose </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>500 mg OD to 2550 mg/day</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>First-line treatment for <strong>type 2 <span class=\"customMeta\" data-dictid=\"b6a934c67b16927771868fca92baf9\">diabetes mellitus</span> (T2DM).</strong></li>\n<li><strong>Prophylaxis in prediabetes</strong> or impaired <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> tolerance.</li>\n<li>Management of <strong>metabolic syndrome</strong> and <strong>PCOS</strong> (promotes ovulation).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Other benefits </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Weight loss in <span class=\"customMeta\" data-dictid=\"43663fecf11692777194c870d1d548\">obese</span> patients and weight <span class=\"customMeta\" data-dictid=\"da9ba55df01692777193ed69860f09\">neutrality</span> in thin patients</li>\n<li>No risk of hypoglycemia, and it leads to a reduction of lipogenesis</li>\n<li>Decreases micro- and <span class=\"customMeta\" data-dictid=\"c33e0939ff1692777191af7082a7ce\">macrovascular</span> complications of DM</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Common: Nausea, vomiting, diarrhea.</li>\n<li>Rare but serious: <strong>Lactic acidosis</strong></li>\n<li>Reduces vitamin B12 absorption, causing <strong>megaloblastic anemia.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a selective estrogen receptor modulator?", "options": [{"label": "A", "text": "Estrogen", "correct": false}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Tamoxifen", "correct": true}, {"label": "D", "text": "Adriamycin", "correct": false}], "correct_answer": "C. Tamoxifen", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tamoxifen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Estrogen <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> (ER) Antagonist</p>\n<p> ↓</p>\n<p>Binds to ER</p>\n<p> ↓</p>\n<p>Tissue-specific effects such as :</p>\n<ul>\n<li>Antagonist in breast tissue (prevents <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> binding).</li>\n<li>Agonist in bone and <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> tissues (estrogen-like effects)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drug of choice for <strong>ER-positive breast cancer.</strong></li>\n<li>Decrease the risk of <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> breast cancer.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Increased risk of endometrial cancer.</li>\n<li>Thromboembolism</li>\n<li>Hot flashes</li>\n<li>Depression</li>\n<li>Hepatotoxicity</li>\n<li>Cataracts.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug Interactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It should not be combined with <span class=\"customMeta\" data-dictid=\"17dda67959169277720303cc6f5bc1\">fluoxetine</span> and other SSRIs.</li>\n<li>SSRIs <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the CYP2D6 enzyme, essential for converting tamoxifen into its active form, endoxifen.</li>\n<li>This interaction may lower endoxifen levels, diminishing tamoxifen's effectiveness against <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> receptor-positive breast cancer.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Exenatide, a recently introduced medication, is employed for the treatment of diabetes mellitus. The drug's mode of action is characterized by:", "options": [{"label": "A", "text": "Inhibition of DPP- 4", "correct": false}, {"label": "B", "text": "Release of insulin via acting as agonist of GLP-1 receptors", "correct": true}, {"label": "C", "text": "Inhibiting intestinal absorption of carbohydrates", "correct": false}, {"label": "D", "text": "Stimulation of PPAR-gamma", "correct": false}], "correct_answer": "B. Release of insulin via acting as agonist of GLP-1 receptors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A lady who had undergone mastectomy for breast cancer is being treated with tamoxifen. How long should it be stopped before she can conceive?", "options": [{"label": "A", "text": "1 month", "correct": false}, {"label": "B", "text": "3 months", "correct": true}, {"label": "C", "text": "No need to stop", "correct": false}, {"label": "D", "text": "Can be stopped and conceived soon after stopping", "correct": false}], "correct_answer": "B. 3 months", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is preferred for management of diabetes in a patient with cardiac and renal failure?", "options": [{"label": "A", "text": "SGLT2 inhibitors", "correct": true}, {"label": "B", "text": "Pioglitazone", "correct": false}, {"label": "C", "text": "Metformin", "correct": false}, {"label": "D", "text": "Sulfonylureas", "correct": false}], "correct_answer": "A. SGLT2 inhibitors", "question_images": [], "explanation_images": [], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ Infections (vaginal thrush, balanoposthitis, Fournier’s gangrene) : Favour the growth of microbes in the lower urinary tract by providing an environment of excessive glucose.</li><li>↳ Infections (vaginal thrush, balanoposthitis, Fournier’s gangrene)</li><li>↳ Euglycemic ketoacidosis is due to inhibiting glucose reabsorption and the body’s preference for ketone bodies as an energy source after excess glucose excretion.</li><li>↳ Euglycemic ketoacidosis</li><li>↳ Osteoporosis: Rarely due to loss of calcium ions upon inhibition of the SGLT-2 receptors.</li><li>↳ Osteoporosis:</li><li>↳ Pioglitazone (Option B) is incorrect because pioglitazone (a thiazolidinedione, TZD) causes fluid retention , worsening heart failure .</li><li>↳ Pioglitazone (Option B)</li><li>↳ pioglitazone (a thiazolidinedione, TZD)</li><li>↳ fluid retention</li><li>↳ heart failure</li><li>↳ Metformin (Option C) is incorrect because although it is the first-line drug for type 2 diabetes , it is contraindicated in severe renal failure (eGFR &lt;30 mL/min/1.73m²) due to the risk of lactic acidosis .</li><li>↳ Metformin (Option C)</li><li>↳ first-line drug for type 2 diabetes</li><li>↳ contraindicated in severe renal failure (eGFR &lt;30 mL/min/1.73m²)</li><li>↳ risk of lactic acidosis</li><li>↳ Sulfonylureas (Option D) is incorrect because sulfonylureas (e.g., glibenclamide, glipizide) increase hypoglycemia risk , especially in renal impairment due to reduced clearance.</li><li>↳ Sulfonylureas (Option D)</li><li>↳ sulfonylureas (e.g., glibenclamide, glipizide)</li><li>↳ hypoglycemia risk</li><li>↳ renal impairment</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the preferred drug for the treatment of postmenopausal breast cancer?", "options": [{"label": "A", "text": "Methotrexate", "correct": false}, {"label": "B", "text": "Raloxifene", "correct": false}, {"label": "C", "text": "Tamoxifen", "correct": false}, {"label": "D", "text": "Anastrozole", "correct": true}], "correct_answer": "D. Anastrozole", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hormonal therapy for breast cancer</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Given for</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Correlation </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tamoxifen</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pre-menopausal hormone receptor-positive breast cancer</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Selective <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"a4dd3586e816927771927d01e3fe29\">modulator</span> (SERM) </strong>works by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> receptors on breast cancer cells, which can slow or stop the growth of tumors that require <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> to grow.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anastrozole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Post-menopausal hormone receptor-positive breast cancer</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Aromatase inhibitors</strong> reduce the production of <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> in the body by <span class=\"customMeta\" data-dictid=\"9dc12b322016927771830dff673eeb\">blocking</span> the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> aromatase, which converts androgens into <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> in <span class=\"customMeta\" data-dictid=\"c9ba8fa63616927771962d84263e40\">postmenopausal</span> women.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fulvestrant</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hormone receptor-positive metastatic breast cancer</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Estrogen <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists </strong>work by binding to <span class=\"customMeta\" data-dictid=\"a58dd68b011692777187eb72633aac\">estrogen</span> receptors and degrading them, which helps to reduce the growth of estrogen-dependent cancer cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Trastuzumab</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>HER2-positive breast cancer</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Monoclonal antibodies </strong>that target the HER2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the growth of cancer cells and can also recruit the body's immune system to destroy these cells.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following adverse effects prevents the use of Teriparatide in a patient with Paget’s disease?", "options": [{"label": "A", "text": "Osteonecrosis of jawbone", "correct": false}, {"label": "B", "text": "Osteosarcoma", "correct": true}, {"label": "C", "text": "Subtrochanteric fractures", "correct": false}, {"label": "D", "text": "Net loss of bone mass", "correct": false}], "correct_answer": "B. Osteosarcoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - O\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following antidiabetic drugs can cause unexplained diarrhea?", "options": [{"label": "A", "text": "Metformin", "correct": true}, {"label": "B", "text": "Glimepiride", "correct": false}, {"label": "C", "text": "Pioglitazone", "correct": false}, {"label": "D", "text": "Sitagliptin", "correct": false}], "correct_answer": "A. Metformin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-diabetic drugs are approved for treatment in heart failure?", "options": [{"label": "A", "text": "SGLT2 inhibitor", "correct": true}, {"label": "B", "text": "DPP-4 inhibitor", "correct": false}, {"label": "C", "text": "GLP-1 inhibitor", "correct": false}, {"label": "D", "text": "Amylin analogues", "correct": false}], "correct_answer": "A. SGLT2 inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - SGLT2 inh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with type 2 diabetes has shown microalbuminuria in two separate urine analyses six months apart, with normal renal function test results. Which of the following is not useful in preventing renal damage progression?", "options": [{"label": "A", "text": "Hydrochlorothiazide", "correct": true}, {"label": "B", "text": "Finerenone", "correct": false}, {"label": "C", "text": "Canagliflozin", "correct": false}, {"label": "D", "text": "Dapagliflozin", "correct": false}], "correct_answer": "A. Hydrochlorothiazide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Hydrochloroth\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A G2P1 delivered a preterm baby at 36 weeks. The baby was admitted to the NICU and given expressed breast milk. Unfortunately, the baby did not survive. What is used to reduce pain and engorgement of the lactating breast in this case?", "options": [{"label": "A", "text": "Pramipexole", "correct": false}, {"label": "B", "text": "Chlorpromazine", "correct": false}, {"label": "C", "text": "Sumatriptan", "correct": false}, {"label": "D", "text": "Cabergoline", "correct": true}], "correct_answer": "D. Cabergoline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Caberg\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs increases the risk of UTI?", "options": [{"label": "A", "text": "Empagliflozin", "correct": true}, {"label": "B", "text": "Glimepiride", "correct": false}, {"label": "C", "text": "Metformin", "correct": false}, {"label": "D", "text": "Sitagliptin", "correct": false}], "correct_answer": "A. Empagliflozin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Empag\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is preferred for a 55-year-old with 150/100mm Hg BP and HbA1c 7.8%?", "options": [{"label": "A", "text": "Metformin", "correct": false}, {"label": "B", "text": "Sitagliptin", "correct": false}, {"label": "C", "text": "Glimipride", "correct": false}, {"label": "D", "text": "Liraglutide", "correct": true}], "correct_answer": "D. Liraglutide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Liraglu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A diabetic patient was on medication and forgot to take his meals before going to the gym. He fainted while exercising, and their blood sugar level was found to be 60 mg/dL. Which of the following antidiabetic drugs can cause hypoglycemia when used in monotherapy?", "options": [{"label": "A", "text": "Sulfonylureas", "correct": true}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Acarbose", "correct": false}, {"label": "D", "text": "Pioglitazone", "correct": false}], "correct_answer": "A. Sulfonylureas", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sulfonylureas</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Site of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pancreatic β cells</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Type 2 Diabetes Mellitus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sulfonylureas ⟶ Bind to Receptors on Pancreatic β Cells ⟶ Closure of <strong>ATP-sensitive K<sup>+</sup> Channels </strong>⟶ Membrane <span class=\"customMeta\" data-dictid=\"dbaf58dd301692777186f2a8d7b3a0\">depolarization</span> ⟶ Opening of Voltage-Gated Ca².+ Channels ⟶ Ca²<sup>+</sup> Influx ⟶ Exocytosis of <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Granules ⟶ Increased <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> Secretion ⟶ Lower Blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">Glucose</span> Levels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1st Generation</p>\n<ul>\n<li>Tolbutamide</li>\n<li>Chlorpropamide</li>\n</ul>\n<p>2nd Generation</p>\n<ul>\n<li>Glibenclamide</li>\n<li>Glipizide</li>\n<li>Gliclazide</li>\n</ul>\n<ul>\n<li>Glimepiride</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old female patient who has been on anti-diabetic therapy for the last 10 years, has experienced three episodes of vaginal candidiasis infections in the past two months. Which hypoglycemic agent should be avoided in this patient?", "options": [{"label": "A", "text": "Acarbose", "correct": false}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Gliflozins", "correct": true}, {"label": "D", "text": "Linagliptin", "correct": false}], "correct_answer": "C. Gliflozins", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A diabetic patient was started on a drug that decreased HbA1c from 7.6 to 6.8. She started complaining of itching around the vulvovaginal area. Which drug was she started on?", "options": [{"label": "A", "text": "Canagliflozin", "correct": true}, {"label": "B", "text": "Metformin", "correct": false}, {"label": "C", "text": "Linagliptin", "correct": false}, {"label": "D", "text": "Liraglutide", "correct": false}], "correct_answer": "A. Canagliflozin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Canag\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An antidiabetic drug causes a decrease in HbA1c by causing an increase in GIP and GLP-1 levels and decrease in glucagon. It is an oral drug causing reduction in both pre and post-prandial glucose. The drug is:", "options": [{"label": "A", "text": "Liraglutide", "correct": false}, {"label": "B", "text": "Pramlintide", "correct": false}, {"label": "C", "text": "Voglibose", "correct": false}, {"label": "D", "text": "Alogliptin", "correct": true}], "correct_answer": "D. Alogliptin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Alog\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication is commonly used as preoperative management for pheochromocytoma to control blood pressure and prevent hypertensive crises?", "options": [{"label": "A", "text": "Captopril", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "Nifedipine", "correct": false}, {"label": "D", "text": "Phenoxybenzamine", "correct": true}], "correct_answer": "D. Phenoxybenzamine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Ph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "How should the steroid therapy be administered for a 55-year-old male diagnosed with Addison's disease?", "options": [{"label": "A", "text": "Bolus dose of 100mg", "correct": false}, {"label": "B", "text": "Bolus of 100mg, followed by 200mg over 24 hours", "correct": true}, {"label": "C", "text": "Bolus of 200 mg, followed by 500 mg over 24 hours", "correct": false}, {"label": "D", "text": "Infusion of 500 mg over 24 hours", "correct": false}], "correct_answer": "B. Bolus of 100mg, followed by 200mg over 24 hours", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"8d138d554c16927771835be732558c\"&gt;Bolus&lt;/span&gt; of 100mg, followed by 200mg over 24 hou\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following drugs are used in the management of thyroid storm except:", "options": [{"label": "A", "text": "Propranolol", "correct": false}, {"label": "B", "text": "Lugol’s iodine", "correct": false}, {"label": "C", "text": "Propylthiouracil", "correct": false}, {"label": "D", "text": "Aspirin", "correct": true}], "correct_answer": "D. Aspirin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to the emergency department with a blood pressure of 90/60 mmHg. There was a history of a local doctor prescribing him some drugs for rheumatoid arthritis (RA) a few weeks ago, and he suddenly stopped taking them. On investigations, there was a serum potassium (K) level of 6.5 mEq/L, sodium (Na) level of 139 mEq/L, signs of dehydration, hypotension (90/40), and a blood glucose level of 40 mg/dL. Which of the following drugs should be used for the life-saving treatment of this patient?", "options": [{"label": "A", "text": "Hydrocortisone", "correct": true}, {"label": "B", "text": "Sodium bicarbonate", "correct": false}, {"label": "C", "text": "Insulin", "correct": false}, {"label": "D", "text": "Hypertonic saline", "correct": false}], "correct_answer": "A. Hydrocortisone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following newly approved anti-diabetic drugs can be given for heart failure with reduced ejection fraction and impaired renal function?", "options": [{"label": "A", "text": "Empagliflozin", "correct": true}, {"label": "B", "text": "Linagliptin", "correct": false}, {"label": "C", "text": "Rosiglitazone", "correct": false}, {"label": "D", "text": "Insulin degludec", "correct": false}], "correct_answer": "A. Empagliflozin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with anxiety, restlessness, tremors and fever. His BP is 180/110 mmHg and atrial fibrillation is detected on ECG. He also has a history of asthma. What drug should be given next?", "options": [{"label": "A", "text": "Esmolol", "correct": false}, {"label": "B", "text": "Propranolol", "correct": false}, {"label": "C", "text": "PTU", "correct": false}, {"label": "D", "text": "Diltiazem", "correct": true}], "correct_answer": "D. Diltiazem", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Levothyroxine/liothyronine acts by binding to thyroid receptors . Thyroid hormone receptors belong to which of the following class of receptors ?", "options": [{"label": "A", "text": "Transmembrane receptor linked to tyrosine kinase", "correct": false}, {"label": "B", "text": "Nuclear receptor", "correct": true}, {"label": "C", "text": "Ion channel receptor", "correct": false}, {"label": "D", "text": "G protein-coupled receptor", "correct": false}], "correct_answer": "B. Nuclear receptor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Nu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "SGLT-2 inhibitors are recently used for type -2 diabetes mellitus . Which of the following are the rare but serious side effects ? 1. Ketoacidosis 2. Urosepsis 3. Fournier gangrene 4. Angioedema", "options": [{"label": "A", "text": "1, 2 &amp;amp; 4 are correct", "correct": false}, {"label": "B", "text": "1, 2 &amp;amp; 3 are correct", "correct": true}, {"label": "C", "text": "Only 4 is correct", "correct": false}, {"label": "D", "text": "All are correct", "correct": false}], "correct_answer": "B. 1, 2 &amp; 3 are correct", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - 1, 2 &amp;amp; 3\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Purpose of adding zinc to insulin in commercial preparations for treatment of diabetes mellitus is:", "options": [{"label": "A", "text": "To make it long acting", "correct": true}, {"label": "B", "text": "To make it short acting", "correct": false}, {"label": "C", "text": "To make is fast acting", "correct": false}, {"label": "D", "text": "Addition of zinc make the insulin effective orally", "correct": false}], "correct_answer": "A. To make it long acting", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - To make it long acting: \n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Insulin Type</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Onset of Action</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Peak Action</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Duration of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Rapid-acting insulin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">15 minutes to 30 minutes</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1 hour to 2 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">3 hours to 5 hours</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Short-acting insulin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">30 minutes to 1 hour</p>\n</td>\n<td>\n<p style=\"text-align: center;\">2 hours to 4 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">5 hours to 8 hours</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Intermediate-acting insulin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1 hour to 2 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">4 hours to 12 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">12 hours to 18 hours</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Long-acting insulin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1 hour to 2 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">No pronounced peak</p>\n</td>\n<td>\n<p style=\"text-align: center;\">24 hours to 36 hours</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Ultra-long-acting insulin</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1 hour to 2 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">No pronounced peak</p>\n</td>\n<td>\n<p style=\"text-align: center;\">More than 42 hours</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements accurately describes the effect of T3 and T4 on TRH ?", "options": [{"label": "A", "text": "It activates phospholipase A", "correct": false}, {"label": "B", "text": "It acts on transcription factor", "correct": true}, {"label": "C", "text": "It acts by increasing cAMP", "correct": false}, {"label": "D", "text": "It is a tyrosine kinase receptor", "correct": false}], "correct_answer": "B. It acts on transcription factor", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ZOV4rVxM7fgJSEbqrvTH1715144456.png"], "explanation": "<p>Correct Option B - It acts on &lt;span class=\"customMeta\" data-dictid=\"739aa4b5ea1692777200a636ee075f\"&gt;transcription&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the options hinders the production of glucocorticoid?", "options": [{"label": "A", "text": "Mifepristone", "correct": false}, {"label": "B", "text": "Flutamide", "correct": false}, {"label": "C", "text": "Finasteride", "correct": false}, {"label": "D", "text": "Metyrapone", "correct": true}], "correct_answer": "D. Metyrapone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - M\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following actions leads to a decrease in bone resorption and an increase in bone formation?", "options": [{"label": "A", "text": "Strontium ranelate", "correct": true}, {"label": "B", "text": "Ibandronate", "correct": false}, {"label": "C", "text": "Teriparatide", "correct": false}, {"label": "D", "text": "Calcitonin", "correct": false}], "correct_answer": "A. Strontium ranelate", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/wOGeHSpHJloX5JXDn7Uh1715144297.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"4126a29d6d1692777199a6ca7d64d4\"&gt;Strontium&lt;/span&g\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug name</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Drugs used to increase the activity of osteoblasts</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Drugs used to decrease the activity of osteoclasts</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Teriparatide</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Abaloparatide</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Strontium ranelate (it is called as dual acting drug)</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Bisphosphonates (BPNs)</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Denosumab</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Calcitonin</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Raloxifene</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>X</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>✓</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the prescribed dosage of hydrocortisone for adrenal insufficiency, measured in milligrams per square meter per day?", "options": [{"label": "A", "text": "20", "correct": false}, {"label": "B", "text": "25", "correct": false}, {"label": "C", "text": "10", "correct": true}, {"label": "D", "text": "5", "correct": false}], "correct_answer": "C. 10", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The best approach in the treatment of chronic SIADH is _____________:", "options": [{"label": "A", "text": "Tolvaptan", "correct": true}, {"label": "B", "text": "Reducing fluid intake to &amp;lt;500 ml per day", "correct": false}, {"label": "C", "text": "Demeclocycline", "correct": false}, {"label": "D", "text": "Fludrocortisone", "correct": false}], "correct_answer": "A. Tolvaptan", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Tolv\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Shortest acting corticosteroid is?", "options": [{"label": "A", "text": "Dexamethasone", "correct": false}, {"label": "B", "text": "Hydrocortisone", "correct": true}, {"label": "C", "text": "Triamcinolone", "correct": false}, {"label": "D", "text": "Deflazacort", "correct": false}], "correct_answer": "B. Hydrocortisone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - H\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Duration of action</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Steroid</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Glucocorticoid activity</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Mineralocorticoids activity</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\">\n<p style=\"text-align: center;\"><strong>Short acting (t<sup>1/2</sup> &lt;12 hr)</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Hydrocortisone (cortisol)</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1</p>\n</td>\n<td>\n<p style=\"text-align: center;\">1</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Cortisone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.8</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.8</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\">\n<p style=\"text-align: center;\"><strong>Intermediate acting (t<sup>1/2</sup> 12-36 hrs)</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Prednisolone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">4</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.8</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Prednisone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">4</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.8</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Methyl Prednisolone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">5</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.5</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Triamcilone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">5</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Deflazocort</p>\n</td>\n<td>\n<p style=\"text-align: center;\">3-4</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\">\n<p style=\"text-align: center;\"><strong>Long</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Betamethasone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">25</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Dexamethasone</p>\n</td>\n<td>\n<p style=\"text-align: center;\">25</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Mechanism of action of exenatide in diabetes mellitus is:", "options": [{"label": "A", "text": "It is an analogue of GLP and increases glucose dependent insulin secretion", "correct": true}, {"label": "B", "text": "It is DPP-4 inhibitor and result in decreased breakdown of GLP", "correct": false}, {"label": "C", "text": "It inhibits SGLT2 and cause glucosuria", "correct": false}, {"label": "D", "text": "It is amylin analogue and decrease glucagon", "correct": false}], "correct_answer": "A. It is an analogue of GLP and increases glucose dependent insulin secretion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - It is an &lt;span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\"&gt;analogue&lt;/span&gt; of &lt;span class=\"customMeta\" data-dictid=\"a269dd4eda1692777188df922d4058\"&gt;GLP&lt;/span&gt; and increases glucose-dependent &lt;span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\"&gt;insulin&lt;/span&g\n<table>\n<tbody>\n<tr>\n<td style=\"text-align:center\"><strong>Medication Class</strong></td>\n<td style=\"text-align:center\"><strong>Examples</strong></td>\n</tr>\n<tr>\n<td>Biguanides</td>\n<td>Metformin</td>\n</tr>\n<tr>\n<td>Sulfonylureas</td>\n<td>Glimepiride, Glipizide, Glyburide</td>\n</tr>\n<tr>\n<td>Meglitinides</td>\n<td>Repaglinide, Nateglinide</td>\n</tr>\n<tr>\n<td>Thiazolidinediones (TZDs)</td>\n<td>Pioglitazone, Rosiglitazone</td>\n</tr>\n<tr>\n<td>Dipeptidyl Peptidase-4 (DPP-4) Inhibitors</td>\n<td>Sitagliptin, Saxagliptin, Linagliptin</td>\n</tr>\n<tr>\n<td>Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors</td>\n<td>Canagliflozin, Dapagliflozin, Empagliflozin</td>\n</tr>\n<tr>\n<td>Alpha-Glucosidase Inhibitors</td>\n<td>Acarbose, Miglitol</td>\n</tr>\n<tr>\n<td>Bile Acid Sequestrants</td>\n<td>Colesevelam</td>\n</tr>\n<tr>\n<td>Dopamine-2 Agonists</td>\n<td>Bromocriptine</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred medication for treating hyperthyroidism during the third trimester of pregnancy?", "options": [{"label": "A", "text": "Carbimazole", "correct": true}, {"label": "B", "text": "Propylthiouracil", "correct": false}, {"label": "C", "text": "Sodium iodide", "correct": false}, {"label": "D", "text": "Radioactive iodine", "correct": false}], "correct_answer": "A. Carbimazole", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following conditions is non-pulsatile dosing of GnRH agonist not used?", "options": [{"label": "A", "text": "Male infertility", "correct": true}, {"label": "B", "text": "Endometriosis", "correct": false}, {"label": "C", "text": "Precocious puberty", "correct": false}, {"label": "D", "text": "Prostate cancer", "correct": false}], "correct_answer": "A. Male infertility", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - M\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Use of Non-Pulsatile GnRH Agonist</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Prostate cancer</strong></p>\n</td>\n<td>\n<p>Used as <span class=\"customMeta\" data-dictid=\"426898277b1692777181c2186c29da\">androgen</span> <span class=\"customMeta\" data-dictid=\"0a5bb4dd4116927771860470a5e991\">deprivation</span> therapy (ADT) to suppress <span class=\"customMeta\" data-dictid=\"e54a6646c1169277720031d162bd75\">testosterone</span> production and slow down the growth of <span class=\"customMeta\" data-dictid=\"19c0231fc41692777196ffce23771d\">prostate</span> cancer cells</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Uterine fibroids</strong></p>\n</td>\n<td>\n<p>Used to shrink the size of <span class=\"customMeta\" data-dictid=\"59ff8b38191692777201150e72ebc3\">uterine</span> fibroids and alleviate associated symptoms such as heavy <span class=\"customMeta\" data-dictid=\"3a03cad6c616927771925038b55989\">menstrual</span> <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> and <span class=\"customMeta\" data-dictid=\"7cd6eb19341692777195d83aafdcb3\">pelvic</span> pain</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Endometriosis</strong></p>\n</td>\n<td>\n<p>Used to suppress the growth and activity of endometrial tissue outside the uterus, reducing pain and other symptoms</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Precocious puberty</strong></p>\n</td>\n<td>\n<p>Used to delay the onset of <span class=\"customMeta\" data-dictid=\"c284c4252f16927771963c07a95e13\">puberty</span> in children who develop sexual characteristics at an abnormally early age</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Gender dysphoria</strong></p>\n</td>\n<td>\n<p>Used as part of <span class=\"customMeta\" data-dictid=\"be711e5c8316927771895447e0d316\">hormone therapy</span> for individuals seeking gender transition to suppress <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> hormone production</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the most significant side-effect of tamoxifen ?", "options": [{"label": "A", "text": "Cancer in the opposite breast", "correct": false}, {"label": "B", "text": "Osteoporosis", "correct": false}, {"label": "C", "text": "Endometrial hyperplasia", "correct": true}, {"label": "D", "text": "Infertility", "correct": false}], "correct_answer": "C. Endometrial hyperplasia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Endometrial h\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 65 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Given his renal impairment, which class of medications for Peptic ulcer disease should be avoided, and which specific agent would provide the most optimal relief without exacerbating his comorbid conditions as well as for long-term use?", "options": [{"label": "A", "text": "Avoid proton pump inhibitors; use ranitidine.", "correct": false}, {"label": "B", "text": "Avoid antacids containing magnesium; use omeprazole.", "correct": true}, {"label": "C", "text": "Avoid H2 receptor antagonists; use sucralfate.", "correct": false}, {"label": "D", "text": "Avoid proton pump inhibitors; use calcium carbonate.", "correct": false}], "correct_answer": "B. Avoid antacids containing magnesium; use omeprazole.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ZGGyxcwVeq7k39g8tvyl1724060805.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old primigravida presents with complaints of recurrent heartburn and epigastric discomfort. She has a history of closed-angle glaucoma, which is currently well-managed with medication. Considering her medical history, which combination of acid-suppressant drugs should be avoided?", "options": [{"label": "A", "text": "PPIs only", "correct": false}, {"label": "B", "text": "H2 blockers only", "correct": false}, {"label": "C", "text": "Anticholinergics only", "correct": false}, {"label": "D", "text": "Anticholinergics and Prostaglandin analogues", "correct": true}], "correct_answer": "D. Anticholinergics and Prostaglandin analogues", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:670px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:214px\">\n<p style=\"text-align: center;\"><strong>Acid <span class=\"customMeta\" data-dictid=\"f0458fc52216927771996d276de3c4\">Suppressant</span> Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:456px\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:214px\">\n<p style=\"text-align: center;\"><strong>Proton Pump Inhibitors (PPIs) (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:456px\">\n<p style=\"text-align: center;\">Irreversibly <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the H+/K+ <span class=\"customMeta\" data-dictid=\"597e455849169277718275e4dc5936\">ATPase</span> pump in the <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells, leading to sustained <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> acid secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:214px\">\n<p style=\"text-align: center;\"><strong>H2 Blockers (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:456px\">\n<p style=\"text-align: center;\">Competitively antagonizes <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> H2 receptors on the surface of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells, thereby diminishing the <span class=\"customMeta\" data-dictid=\"e33367d4a31692777199bb835a83ea\">stimulatory</span> effect of <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> on the production of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> acid.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:214px\">\n<p style=\"text-align: center;\"><strong>Prostaglandin Analogues</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:456px\">\n<p style=\"text-align: center;\">Stimulate <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> E2 receptors on <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> epithelial cells, promoting the <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> of <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> and <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> while inhibiting <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> acid secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:214px\">\n<p style=\"text-align: center;\"><strong>Anticholinergics (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:456px\">\n<p style=\"text-align: center;\">Act as competitive antagonists at M3 <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors in the stomach, inhibiting the <span class=\"customMeta\" data-dictid=\"e33367d4a31692777199bb835a83ea\">stimulatory</span> effects of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> on <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> acid <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> and motility.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 42-year-old man presents with heartburn and epigastric pain, diagnosed with peptic ulcer disease. The doctor opts for a PPI, choosing between Ilaprazole, Lansoprazole, Rabeprazole and Omeprazole. Which of these medications requires the lowest dosage to achieve equivalent therapeutic effects?", "options": [{"label": "A", "text": "Ilaprazole", "correct": true}, {"label": "B", "text": "Lansoprazole", "correct": false}, {"label": "C", "text": "Rabeprazole", "correct": false}, {"label": "D", "text": "Omeprazole", "correct": false}], "correct_answer": "A. Ilaprazole", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 68-year-old female patient with a history of myocardial infarction is currently on dual antiplatelet therapy, including clopidogrel. She visited a government hospital where an intern prescribed her omeprazole to be taken in the morning, not knowing that omeprazole is contraindicated with clopidogrel. Which Cytochrome P450 enzyme is implicated with respect to the reduced effectiveness of clopidogrel when taking omeprazole?", "options": [{"label": "A", "text": "CYP2C9", "correct": false}, {"label": "B", "text": "CYP2C19", "correct": true}, {"label": "C", "text": "CYP3A4", "correct": false}, {"label": "D", "text": "CYP2D6", "correct": false}], "correct_answer": "B. CYP2C19", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is incorrect with respect to the adverse effects of chronic use of proton pump inhibitors (PPI)?", "options": [{"label": "A", "text": "Use of PPI is associated with reduced absorption of B12, Mg, and Iron.", "correct": false}, {"label": "B", "text": "Long-term use of PPI is associated with an increased risk of bone fractures.", "correct": false}, {"label": "C", "text": "Increased risk of pseudomembranous enterocolitis is associated with long-term use of PPI.", "correct": false}, {"label": "D", "text": "Reduced serum gastrin levels can occur due to long-term use of PPI, causing ECL hyperplasia and atrophic gastritis.", "correct": true}], "correct_answer": "D. Reduced serum gastrin levels can occur due to long-term use of PPI, causing ECL hyperplasia and atrophic gastritis.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 38-year-old male with a history of frequent episodes of acidity was prescribed an H2 receptor antagonist. During a follow-up visit, he reports loss of libido and erectile dysfunction. Laboratory tests reveal elevated prolactin levels. Which of the following is the most likely cause of these symptoms?", "options": [{"label": "A", "text": "Ranitidine", "correct": false}, {"label": "B", "text": "Famotidine", "correct": false}, {"label": "C", "text": "Nizatidine", "correct": false}, {"label": "D", "text": "Cimetidine", "correct": true}], "correct_answer": "D. Cimetidine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old woman seeks advice on medication to prevent gastric ulcers. She has a history of rheumatoid arthritis and has been on long-term NSAID therapy. Her medical history reveals no contraindications to the use of prostaglandin analogues. The physician considers prescribing Misoprostol for ulcer prevention. Which of the following is the most appropriate counseling point regarding the use of Misoprostol in this patient?", "options": [{"label": "A", "text": "Misoprostol should be taken on an empty stomach to enhance absorption.", "correct": false}, {"label": "B", "text": "Misoprostol is contraindicated in women of childbearing potential unless they are using effective contraception.", "correct": true}, {"label": "C", "text": "Misoprostol can be safely used in patients with a history of allergy to prostaglandins.", "correct": false}, {"label": "D", "text": "Misoprostol works by inhibiting the H2 receptors in the stomach lining to reduce acid secretion.", "correct": false}], "correct_answer": "B. Misoprostol is contraindicated in women of childbearing potential unless they are using effective contraception.", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding the use of Bismuth compounds in ulcer treatment?", "options": [{"label": "A", "text": "They inhibit the proton pump in gastric parietal cells.", "correct": false}, {"label": "B", "text": "They form a protective layer over the ulcer base, shielding it from acid and pepsin.", "correct": true}, {"label": "C", "text": "They primarily act as antacids.", "correct": false}, {"label": "D", "text": "They are H2 receptor antagonists.", "correct": false}], "correct_answer": "B. They form a protective layer over the ulcer base, shielding it from acid and pepsin.", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:645px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Bismuth</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sucralfate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Properties</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Water-soluble, but precipitates when pH &lt;5.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Basic <span class=\"customMeta\" data-dictid=\"267416c084169277718117fb653ded\">aluminium</span> salt of sulfated sucrose. Polymerises at pH &lt;4, forming a sticky gel-like consistency.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mechanism of Action</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases production of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> mucosal <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> E, mucus, and bicarbonate.</li>\n<li>Precipitate <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> glycoproteins and coat the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> base.</li>\n<li>Detach and <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <span class=\"customMeta\" data-dictid=\"313a9372811692777188be2ca0dedc\">Helicobacter</span> pylori directly.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Precipitates surface proteins at the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> base, creating a physical barrier against acid, pepsin, and bile.</li>\n<li>Does not neutralise acid but delays <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying.</li>\n<li>Potentially augments <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> mucosal <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> for additional protection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dosage and Administration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>120 mg taken half an hour before the three major meals and at bedtime for 4-8 weeks.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1 <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">gram</span> taken on an empty stomach one hour before the three major meals and at bedtime for 4-8 weeks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Side Effects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diarrhoea</li>\n<li>Headachy</li>\n<li>Dizziness</li>\n<li>Blackening of the tongue, dentures, and stools.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Constipation</li>\n<li>Hypophosphatemia</li>\n<li>Dry mouth</li>\n<li>Nausea</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Indications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gastritis and non-ulcer <span class=\"customMeta\" data-dictid=\"906574b8861692777186f3a92513db\">dyspepsia</span> associated with H. pylori.</li>\n<li>Occasionally used as part of a triple-drug regimen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bile reflux, <span class=\"customMeta\" data-dictid=\"7861e10657169277718815c2f42a75\">gastritis</span> and <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of stress ulcers.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following clinical features is characteristic of Milk-Alkali Syndrome?", "options": [{"label": "A", "text": "Hyperkalemia", "correct": false}, {"label": "B", "text": "Metabolic acidosis", "correct": false}, {"label": "C", "text": "Hypercalcemia", "correct": true}, {"label": "D", "text": "Hypophosphatemia", "correct": false}], "correct_answer": "C. Hypercalcemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Excess <span class=\"customMeta\" data-dictid=\"6cdcd39cf2169277719068e247e38d\">intake</span> of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> + <span class=\"customMeta\" data-dictid=\"330e2bf7d216927771804326d05181\">absorbable</span> <span class=\"customMeta\" data-dictid=\"b802ae0373169277718153c4d4fbaf\">alkali</span> (e.g., <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> carbonate)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Lab Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypercalcemia, <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> alkalosis, Hypophosphatemia, Low PTH</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, weakness, mental status changes, polyuria, <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> injury</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Calcium-induced <span class=\"customMeta\" data-dictid=\"09562877f516927771865e4cf1fd7e\">diuresis</span> → volume <span class=\"customMeta\" data-dictid=\"7061e0e0051692777186ba9c5f27df\">depletion</span> → increased <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Discontinue offending agents, IV hydration, <span class=\"customMeta\" data-dictid=\"1848b160c11692777191b60caaf622\">loop diuretics</span> if needed</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/leSdZP08mcQPdWcvwyHp1747298144.mp3", "video": ""}, {"text": "A 68 y/o female presents to the emergency department with severe abdominal pain, bloating and difficulty breathing. She has a H/O CKD and GERD. The patient admits to using sodium bicarbonate antacids frequently to manage her GERD symptoms. On examination, her abdomen is distended and she exhibits signs of peritonitis. An abdominal X-ray reveals free air under the diaphragm. Which of the following is the most likely cause of the patient's symptoms?", "options": [{"label": "A", "text": "Hyperkalemia from excessive sodium bicarbonate use.", "correct": false}, {"label": "B", "text": "Excessive gas production from sodium bicarbonate neutralising stomach acid.", "correct": true}, {"label": "C", "text": "Hypocalcemia-induced muscle spasms causing bowel rupture.", "correct": false}, {"label": "D", "text": "Hypermagnesemia from concomitant use of magnesium-containing antacids.", "correct": false}], "correct_answer": "B. Excessive gas production from sodium bicarbonate neutralising stomach acid.", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25 y/o female, a competitive gymnast presents with complaints of heartburn. She has a history of regular consumption of dairy-based calcium supplements for the past 5 years to help with her athletic lifestyle. She insists the doctor prescribe her calcium-based antacids. The doctor suggests against it and explains to her the reason. Why did the doctor suggest against it?", "options": [{"label": "A", "text": "Risk of developing diarrhea", "correct": false}, {"label": "B", "text": "Risk of developing osteoporosis", "correct": false}, {"label": "C", "text": "Risk of developing milk-alkali syndrome", "correct": true}, {"label": "D", "text": "Risk of developing hypertension and edema", "correct": false}], "correct_answer": "C. Risk of developing milk-alkali syndrome", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old woman with a history of CHF (congestive heart failure) presents to the clinic complaining of heartburn, chest pain, and regurgitation of food after meals for the past week. Her CHF symptoms are currently well-controlled with medication. On examination, there is no evidence of angina pectoris. Which medication would be MOST APPROPRIATE for this patient’s symptoms?", "options": [{"label": "A", "text": "Magaldrate", "correct": true}, {"label": "B", "text": "Sodium Bicarbonate", "correct": false}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Metoprolol", "correct": false}], "correct_answer": "A. Magaldrate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5y/o girl is brought to the emergency department by her parents with complaints of persistent vomiting, confusion, and lethargy. The parents mentioned that she had a viral illness two weeks prior, during which she was given a combination of medications to alleviate her symptoms. On examination, the child is found to be drowsy, with signs of hepatomegaly. Laboratory tests reveal elevated liver enzymes and ammonia levels. Which of the following medications is most likely associated with the child's current presentation?", "options": [{"label": "A", "text": "Paracetamol", "correct": false}, {"label": "B", "text": "Amoxicillin", "correct": false}, {"label": "C", "text": "Bismuth subsalicylate", "correct": true}, {"label": "D", "text": "Ranitidine", "correct": false}], "correct_answer": "C. Bismuth subsalicylate", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male patient presents with symptoms of peptic ulcer disease and is diagnosed with H. pylori infection. He is allergic to penicillin. As part of his initial treatment, you decide to start him on triple therapy for H. pylori eradication. Which of the following drugs are used in Triple therapy in this patient?", "options": [{"label": "A", "text": "PPI + Clarithromycin + Metronidazole for 14 days", "correct": true}, {"label": "B", "text": "PPI + Clarithromycin + Amoxicillin for 14 days", "correct": false}, {"label": "C", "text": "PPI + Levofloxacin + Clarithromycin for 14 days", "correct": false}, {"label": "D", "text": "PPI + Clarithromycin + Metronidazole for 7 days", "correct": false}], "correct_answer": "A. PPI + Clarithromycin + Metronidazole for 14 days", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antibiotics used against H. Pylori:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clarithromycin</p>\n<p>Amoxicillin</p>\n<p>Metronidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1st generation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tetracycline</p>\n<p>Levofloxacine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2nd generation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rifabutin</p>\n<p>Furazolidone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3rd generation</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:699px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-H.pylori regimens:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs used</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No. of days:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triple therapy: PCA</p>\n<p>(first line therapy used)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + <span class=\"customMeta\" data-dictid=\"d1e73ea72b1692777181fe0162bd92\">Amoxicillin</span> <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triple therapy: PCM</p>\n<p>(in case of <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> or resistance) </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + Metronidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Levofloxacin-based triple therapy: </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"938a61d0181692777191d07720a9c2\">Levofloxacin</span> + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> (PAL) <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Yg9ER4CCyZZ49WnFpbe01747763727.mp3", "video": ""}, {"text": "Which of the following is the most preferred treatment regimen for H pylori in India?", "options": [{"label": "A", "text": "Triple therapy", "correct": false}, {"label": "B", "text": "Quadruple therapy", "correct": true}, {"label": "C", "text": "Sequential therapy", "correct": false}, {"label": "D", "text": "Hybrid therapy", "correct": false}], "correct_answer": "B. Quadruple therapy", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:721px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-H.pylori regimens:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs used</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No. of days:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triple therapy: PCM</p>\n<p>(in case of <span class=\"customMeta\" data-dictid=\"7f576b591a1692777195da1639d0fe\">penicillin</span> <span class=\"customMeta\" data-dictid=\"aa1288c36b16927771814fa5aa84eb\">allergy</span> or resistance) </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + Metronidazole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Triple therapy: PCA </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + Amoxicillin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Quadruple therapy (In <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">clarithromycin</span> resistance)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"2940cc0ecd169277718375b839902c\">Bismuth</span> salts + <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">Metronidazole</span> + Tetracycline</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD for 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sequential therapy </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"d1e73ea72b1692777181fe0162bd92\">Amoxicillin</span> (for 7 days) ➞ <span class=\"customMeta\" data-dictid=\"6d17c6d6f1169277719687447037f2\">PPI</span> + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">Metronidazole</span> (for 7 days)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD For 14 days</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hybrid therapy </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PPI + <span class=\"customMeta\" data-dictid=\"d1e73ea72b1692777181fe0162bd92\">Amoxicillin</span> (for 7 days)➞ <span class=\"customMeta\" data-dictid=\"6d17c6d6f1169277719687447037f2\">PPI</span> + <span class=\"customMeta\" data-dictid=\"00c4a4fe9b1692777184136ffde6c9\">Clarithromycin</span> + <span class=\"customMeta\" data-dictid=\"d1e73ea72b1692777181fe0162bd92\">Amoxicillin</span> + <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">Metronidazole</span> (for 7 days)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>BD For 14 days</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old patient with a history of gastroesophageal reflux disease (GERD) reports persistent symptoms despite lifestyle modifications and dietary changes. The physician decides to add alginic acid to the patient's treatment regimen. What is the mechanism of action of alginic acid in the treatment of GERD?", "options": [{"label": "A", "text": "Makes a neutral covering over HCL", "correct": true}, {"label": "B", "text": "Bursts bubbles in the gastrointestinal tract", "correct": false}, {"label": "C", "text": "Increases prostaglandin synthesis", "correct": false}, {"label": "D", "text": "Polymerizes with proteins to form a protective covering", "correct": false}], "correct_answer": "A. Makes a neutral covering over HCL", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/mjZ3le2GkhWEVGeU6MOG1724064188.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 26 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "All of the following are contraindications of emetics except?", "options": [{"label": "A", "text": "Corrosive ingestion", "correct": false}, {"label": "B", "text": "Unconscious patient", "correct": false}, {"label": "C", "text": "CNS stimulant toxicity", "correct": false}, {"label": "D", "text": "Parkinson's disease", "correct": true}], "correct_answer": "D. Parkinson's disease", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old woman is just being shifted to the recovery room after an appendectomy. She feels nauseous. Which of the following is the most appropriate antiemetic for this patient?", "options": [{"label": "A", "text": "Ondansetron", "correct": true}, {"label": "B", "text": "Aprepitant", "correct": false}, {"label": "C", "text": "Domperidone", "correct": false}, {"label": "D", "text": "Hyoscine", "correct": false}], "correct_answer": "A. Ondansetron", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:703px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Anticholinergic (M1 receptor)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Hyoscine (scopolamine) </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC: <span class=\"customMeta\" data-dictid=\"93772348231692777192fbdc055f11\">motion sickness</span> <strong>(Option D ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Antihistamine (H1 receptor)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Diphenhydramine</p>\n<p style=\"text-align:center\">Promethazine</p>\n<p style=\"text-align:center\">Cyclizine</p>\n<p style=\"text-align:center\">Meclizine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motion sickness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>5HT3 antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Ondansetron </p>\n<p style=\"text-align:center\">Palonosetron</p>\n<p style=\"text-align:center\">Dalosetron</p>\n<p style=\"text-align:center\">Tropisetron</p>\n<p style=\"text-align:center\">Granisetron</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC: early onset chemo-induced vomiting</li>\n<li>DOC:<strong> <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">Postoperative</span> and postradiotherapy-induced <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>D2 blocker</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Metoclopramide</p>\n<p style=\"text-align:center\">Domperidone </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild to moderate vomiting</li>\n<li>GERD <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>NK1 inhibitor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\">Aprepitant</p>\n<p style=\"text-align:center\">Fosaprepitant</p>\n<p style=\"text-align:center\">Netupitant</p>\n<p style=\"text-align:center\">Rolapitant</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>DOC: late-onset chemotherapy-induced vomiting <strong>(Option B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old woman has a history of nausea and vomiting, especially during her journeys. Which of the following would be the most appropriate drug for this patient to prevent the same during her next journey?", "options": [{"label": "A", "text": "Fexofenadine", "correct": false}, {"label": "B", "text": "Hyoscine", "correct": true}, {"label": "C", "text": "Ondansetron", "correct": false}, {"label": "D", "text": "Metoclopramide", "correct": false}], "correct_answer": "B. Hyoscine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/RA9ZjusfMQyXV2pM9PWJ1724071903.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman is undergoing chemotherapy for breast cancer. Despite taking her prescribed antiemetic medication, she experiences significant nausea and vomiting starting 24 hours after her chemotherapy sessions and lasting for several days. Which of the following is the 1st line drug used to relieve this patient’s chemotherapy-induced nausea and vomiting?", "options": [{"label": "A", "text": "Ondansetron", "correct": false}, {"label": "B", "text": "Dronabinol", "correct": false}, {"label": "C", "text": "Fezolinetant", "correct": false}, {"label": "D", "text": "Aprepitant", "correct": true}], "correct_answer": "D. Aprepitant", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/h89giImHZ6t0ubl3ODEb1724072148.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bznElPzHUpuPMNef0ae61746257390.mp3", "video": ""}, {"text": "A 70-year-old man with Parkinson's disease has recently started treatment with levodopa. He reports experiencing significant nausea and vomiting since beginning the medication. Which of the following antiemetics is appropriate for this patient’s condition?", "options": [{"label": "A", "text": "Metoclopramide", "correct": false}, {"label": "B", "text": "Prochlorperazine", "correct": false}, {"label": "C", "text": "Chlorpromazine", "correct": false}, {"label": "D", "text": "Domperidone", "correct": true}], "correct_answer": "D. Domperidone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 64-year-old male patient with a history of lung cancer undergoing chemotherapy comes to the clinic with complaints of dizziness and red eyes for 4 days. He complained of chemotherapy-induced nausea and vomiting 5 days ago, for which he was prescribed an antiemetic. Which of the following antiemetics would have led to his current presentation?", "options": [{"label": "A", "text": "Ondansetron", "correct": false}, {"label": "B", "text": "Metoclopramide", "correct": false}, {"label": "C", "text": "Aprepitant", "correct": false}, {"label": "D", "text": "Dranabinol", "correct": true}], "correct_answer": "D. Dranabinol", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:666px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Side effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Ondansetron </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Constipation, QT interval prolongation, headache <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Metoclopramide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Extrapyramidal side effects (by crossing the blood brain barrier) <strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">Aprepitant </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\">QT interval prolongation <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old female comes to the clinic with complaints of vomiting associated with her migraine headache for the past 2 days. Which of the following can be effective in this patient?", "options": [{"label": "A", "text": "Lorazepam", "correct": false}, {"label": "B", "text": "Nabilone", "correct": false}, {"label": "C", "text": "Prochlorperazine", "correct": true}, {"label": "D", "text": "Dexamethasone", "correct": false}], "correct_answer": "C. Prochlorperazine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female patient presents with mild to moderate pain in the upper right quadrant of her abdomen. Upon ultrasound examination, she is diagnosed with cholesterol gallstones. The physician prescribes ursodeoxycholic acid. Which of the following is the mechanism of action of this drug?", "options": [{"label": "A", "text": "Decreases cholesterol absorption from the intestine", "correct": true}, {"label": "B", "text": "Decreases cholesterol synthesis in the liver", "correct": false}, {"label": "C", "text": "Increases cholesterol breakdown", "correct": false}, {"label": "D", "text": "Increases cholesterol uptake by adipocytes", "correct": false}], "correct_answer": "A. Decreases cholesterol absorption from the intestine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qEON7xt1wghsLDBfJdi31724073563.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female patient presents to the clinic with symptoms of severe malabsorption following an extensive intestinal resection due to Crohn's disease. She has been diagnosed with short bowel syndrome and is currently receiving parenteral nutrition. Which of the following medications is not typically used to treat short bowel syndrome?", "options": [{"label": "A", "text": "Growth hormone", "correct": false}, {"label": "B", "text": "Octreotide", "correct": false}, {"label": "C", "text": "Teduglutide", "correct": false}, {"label": "D", "text": "Ursodeoxycholic acid", "correct": true}], "correct_answer": "D. Ursodeoxycholic acid", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male presents to the clinic with complaints of chronic abdominal pain and significant weight loss over the past year. He reports frequent, bulky and foul-smelling stools. His medical history is significant for alcohol abuse over the past 20 years. Laboratory investigations reveal normal LFT, and imaging studies show calcifications in the pancreas. Considering the patient's clinical presentation and medical history, which of the following is the most appropriate treatment?", "options": [{"label": "A", "text": "Lipase only", "correct": false}, {"label": "B", "text": "Amylase only", "correct": false}, {"label": "C", "text": "Lipase and trypsin", "correct": true}, {"label": "D", "text": "Proteinase and amylase", "correct": false}], "correct_answer": "C. Lipase and trypsin", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old male patient is scheduled for a colonoscopy. Bowel cleaning is required as part of the preparation. Which of the following laxatives would be most appropriate for this purpose?", "options": [{"label": "A", "text": "Bisacodyl", "correct": false}, {"label": "B", "text": "Lactulose", "correct": false}, {"label": "C", "text": "Polyethylene glycol (PEG)", "correct": true}, {"label": "D", "text": "Docusate sodium", "correct": false}], "correct_answer": "C. Polyethylene glycol (PEG)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/l38QZVt9KvKtJm8vUfHB1724065044.jpg", "https://image.prepladder.com/content/A5zCySZ76BRvoaRTRCIL1724065092.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false regarding the mechanism of action of bulk laxatives?", "options": [{"label": "A", "text": "Bulk laxatives mainly act by fermenting laxatives by gut bacteria, which produces short-chain fatty acids and increases bacterial mass in the stool.", "correct": false}, {"label": "B", "text": "Short-chain fatty acids have a prokinetic effect, and bacterial mass increases stool volume.", "correct": false}, {"label": "C", "text": "The more fermentable the laxative, the more the stool bulk and the faster the transit.", "correct": true}, {"label": "D", "text": "Dietary fibres such as lignin resist fermentation, and fibres such as pectins are readily fermented.", "correct": false}], "correct_answer": "C. The more fermentable the laxative, the more the stool bulk and the faster the transit.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2gqbkdpptUCWOVQooCr31724065857.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 70-year-old male presents with severe abdominal distension and discomfort. He reports that he has not had a bowel movement for over a week and has been experiencing nausea and vomiting. Physical examination reveals a significantly distended abdomen with absent bowel sounds. An abdominal X-ray shows a megacolon. Which of the following treatments is contraindicated in this patient due to the condition of atonic colon?", "options": [{"label": "A", "text": "Intravenous fluids for rehydration &amp;amp; parenteral nutrition", "correct": false}, {"label": "B", "text": "Nasogastric decompression to relieve distension", "correct": false}, {"label": "C", "text": "Bulk-forming laxatives to increase stool bulk", "correct": true}, {"label": "D", "text": "Antibiotic therapy for suspected infection", "correct": false}], "correct_answer": "C. Bulk-forming laxatives to increase stool bulk", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old woman with a history of chronic constipation visits her primary care physician. She has been prescribed bisacodyl, a stimulant laxative, to help with her bowel movements. The physician advises her to take the medication before bedtime. What is the BEST explanation for prescribing bisacodyl before bedtime?", "options": [{"label": "A", "text": "Bisacodyl takes 6-8 hours to reach the small bowel, thus needs to be given at bedtime for morning evacuation.", "correct": false}, {"label": "B", "text": "Bisacodyl has an associated sedative effect, thus needs to be prescribed before sleep.", "correct": false}, {"label": "C", "text": "The drug requires hydrolysis by endogenous esterases in the bowel for activation, which takes 6–10 hours on oral dose.", "correct": true}, {"label": "D", "text": "Bisacodyl mechanism of action involves the process of fermentation, which needs 6-8 hours to take place.", "correct": false}], "correct_answer": "C. The drug requires hydrolysis by endogenous esterases in the bowel for activation, which takes 6–10 hours on oral dose.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman with a history of chronic constipation has been using over-the-counter laxatives for several months. During a routine colonoscopy, the gastroenterologist observes the following image. Which of the following is the implicated reason for this condition?", "options": [{"label": "A", "text": "Bisacodyl", "correct": false}, {"label": "B", "text": "Isabgol", "correct": false}, {"label": "C", "text": "Castor Oil", "correct": false}, {"label": "D", "text": "Senna", "correct": true}], "correct_answer": "D. Senna", "question_images": ["https://image.prepladder.com/content/n4vLuP9RGv5ahxurHf1I1724067015.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/css6pKP14pS3zQjwj2sk1746257169.mp3", "video": ""}, {"text": "A 45-year-old male presents with complaints of chronic indigestion, bloating and delayed gastric emptying. After a thorough evaluation, the physician prescribes a prokinetic agent to improve gastrointestinal motility. Which of the following statements about prokinetic agents is false?", "options": [{"label": "A", "text": "Metoclopramide acts as a D2 antagonist and has serotonergic activity, enhancing GI motility.", "correct": false}, {"label": "B", "text": "Domperidone primarily acts as a peripheral D2 receptor antagonist, facilitating gastric emptying and increasing LES tone.", "correct": false}, {"label": "C", "text": "Erythromycin acts as a motilin receptor agonist, mimicking the action of motilin to stimulate gastric contractions.", "correct": false}, {"label": "D", "text": "Cholecystokinin acts on the CCK-A receptor and stimulates stomach contraction, promoting motility.", "correct": true}], "correct_answer": "D. Cholecystokinin acts on the CCK-A receptor and stimulates stomach contraction, promoting motility.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:536px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Class of Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dopamine (D2) <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metoclopramide, Domperidone, Levosulpiride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GERD, gastroparesis, dyspepsia, antiemetic. <strong>(Option A and B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT4 agonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cisapride, Tegaserod (banned due to QT prolongation),</p>\n<p>Mosapride,Prucalopride, Cinitapride, Metoclopramide.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GERD, gastroparesis, dyspepsia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Motilin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erythromycin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> Upper GI haemorrhage to promote <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"397f16a7a71692777187ffffefa7e6\">emptying</span> of blood before endoscopy. <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CCK - A (CCK -1) inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dexloxiglumide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>GERD, IBS, functional dyspepsia, <span class=\"customMeta\" data-dictid=\"281b8ef3701692777185aa34365916\">constipation</span> and gastroparesis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>↑ <span class=\"customMeta\" data-dictid=\"fba05f424716927771802b63f6c392\">ACh</span> levels</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neostigmine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Postoperative <span class=\"customMeta\" data-dictid=\"14bba9af561692777194c8cadacf13\">paralytic</span> ileus</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old woman presents with complaints of chronic GERD and occasional delayed gastric emptying. After a thorough evaluation, the physician decides to prescribe her Mosapride. Which of the following statements regarding Mosapride is false?", "options": [{"label": "A", "text": "Mosapride is a selective 5-HT4 receptor agonist.", "correct": false}, {"label": "B", "text": "Mosapride enhances gastric motility by increasing acetylcholine release.", "correct": false}, {"label": "C", "text": "Mosapride is commonly used to treat gastroesophageal reflux disease (GERD).", "correct": false}, {"label": "D", "text": "Mosapride is a Motilin receptor stimulant.", "correct": true}], "correct_answer": "D. Mosapride is a Motilin receptor stimulant.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:538px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Prokinetic Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Primary Receptor(s) Targeted</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mosapride</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-HT4 receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Agonist of 5-HT4 receptors; increases release of acetylcholine, enhancing <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> motility. </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metoclopramide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D2 receptors, 5-HT4 receptors, 5-HT3 receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antagonist of D2 and 5-HT3 receptors; <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> of 5-HT4 receptors; enhances <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">motility</span> and <span class=\"customMeta\" data-dictid=\"b676cf039416927771814f87114511\">antiemetic</span> effect.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Domperidone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D2 receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> of D2 receptors increases <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">acetylcholine</span> release, enhancing <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> motility.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Erythromycin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Motilin receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Agonist of <span class=\"customMeta\" data-dictid=\"a062a7dd1116927771929e698991a9\">motilin</span> receptors; mimics motilin, stimulating <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> motility.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 23-year-old female presents with complaints of severe nausea and vomiting for the past three days. She has a history of migraine headaches and recently started taking metoclopramide to manage her symptoms. On examination, the patient appears anxious and has abnormal facial movements, including grimacing and involuntary movements of her neck and shoulders. Which of the following is the most likely diagnosis for this patient's symptoms?", "options": [{"label": "A", "text": "Serotonin syndrome", "correct": false}, {"label": "B", "text": "Acute dystonia", "correct": true}, {"label": "C", "text": "Neuroleptic malignant syndrome", "correct": false}, {"label": "D", "text": "Allergic reaction", "correct": false}], "correct_answer": "B. Acute dystonia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male with a history of cirrhosis secondary to chronic hepatitis C presents with altered mental status. He is disoriented to time and place and has asterixis on physical examination. His family reports that he has been non-compliant with his medications, including lactulose. Laboratory tests reveal elevated serum ammonia levels. Which of the following is the primary mechanism by which lactulose helps in the management of hepatic encephalopathy in this patient?", "options": [{"label": "A", "text": "Lactulose reduces serum ammonia levels by promoting its excretion through urine.", "correct": false}, {"label": "B", "text": "Lactulose acts as a sedative to reduce agitation and improve mental status.", "correct": false}, {"label": "C", "text": "Lactulose acidifies the colonic contents, converting ammonia to ammonium, which is less readily absorbed.", "correct": true}, {"label": "D", "text": "Lactulose directly binds to ammonia in the bloodstream, facilitating its elimination.", "correct": false}], "correct_answer": "C. Lactulose acidifies the colonic contents, converting ammonia to ammonium, which is less readily absorbed.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 28-year-old pregnant woman at 24 weeks of gestation presents with complaints of constipation for the past two weeks. She is concerned about using medications that might affect her pregnancy. The obstetrician discusses the use of stool softeners to alleviate her symptoms. Which of the following is the most appropriate stool softener to recommend for this patient?", "options": [{"label": "A", "text": "Bisacodyl", "correct": false}, {"label": "B", "text": "Docusate sodium", "correct": true}, {"label": "C", "text": "Magnesium citrate", "correct": false}, {"label": "D", "text": "Senna", "correct": false}], "correct_answer": "B. Docusate sodium", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UdMZfHH9SyBZuQDcAgrD1724068390.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old female presents with a chronic history of watery diarrhoea for the past 4 months, up to 10 times daily. She reports significant weight loss despite maintaining a good appetite. Blood tests reveal mild hypokalemia. Stool analysis shows no faecal pathogens. Abdominal imaging identifies a small pancreatic mass. Further hormonal testing demonstrates elevated vasoactive intestinal peptide (VIP) levels. Which of the following medications is most likely to be beneficial for controlling the patient's diarrhoea?", "options": [{"label": "A", "text": "Loperamide", "correct": false}, {"label": "B", "text": "Metronidazole", "correct": false}, {"label": "C", "text": "Octreotide", "correct": true}, {"label": "D", "text": "Diphenoxylate with Atropine", "correct": false}], "correct_answer": "C. Octreotide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old woman presents to the clinic with complaints of cramping abdominal pain and irregular bowel movements, including episodes of both diarrhea and constipation. She mentions occasional mucus in her stool but denies any recent travel, bloody stools, or weight loss. She also reports feeling increasingly stressed due to work deadlines. Her stool culture and other lab results are found to be normal. Which of the following would not be an ideal treatment option for her?", "options": [{"label": "A", "text": "Psyllium", "correct": false}, {"label": "B", "text": "Dicyclomine", "correct": false}, {"label": "C", "text": "Alosetron", "correct": false}, {"label": "D", "text": "Rifaximin", "correct": true}], "correct_answer": "D. Rifaximin", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/iMtb0wiEKvlCXiJsZyPN1724068833.jpg"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old male presents with a 6-month history of chronic diarrhea, cramping abdominal pain, and bloating. He reports that his symptoms are exacerbated by stress. There is no h/o rectal bleeding, weight loss, or mucous in the stools. On physical exam, his abdomen is mildly distended with diffuse tenderness but no masses. His lab values are normal. His doctor suspects he has diarrhoea-dominant IBS (IBS-D). Which of the following treatments should be avoided in this patient?", "options": [{"label": "A", "text": "Loperamide", "correct": false}, {"label": "B", "text": "Alosetron", "correct": true}, {"label": "C", "text": "Hyoscyamine", "correct": false}, {"label": "D", "text": "Fluoxetine", "correct": false}], "correct_answer": "B. Alosetron", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:591px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-HT3 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IBS-D (Diarrhea-predominant IBS)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Approved population</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Women only</strong> with severe IBS-D not responding to other therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Not approved in</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Males</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Major adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ischemic colitis, severe constipation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Regulation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prescribed under strict REMS program</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 38-year-old female presents with abdominal pain, bloating, and diarrhoea for the past week. She mentions that she was recently treated with a 7-day course of amoxicillin for a sinus infection. On further questioning, she reports no fever or blood in the stool. A stool sample is negative for common pathogens and parasites. The physician suspects antibiotic-associated diarrhoea. Which of the following medications is most appropriate next best to alleviate the patient’s symptoms?", "options": [{"label": "A", "text": "Metronidazole", "correct": false}, {"label": "B", "text": "Lactobacillus", "correct": true}, {"label": "C", "text": "Rifaximin", "correct": false}, {"label": "D", "text": "Loperamide", "correct": false}], "correct_answer": "B. Lactobacillus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old female with breast cancer is undergoing chemotherapy with cisplatin. Despite receiving antiemetics during the initial 24 hours, she experiences nausea and vomiting 48 hours after chemotherapy. Which of the following drugs below is most effective in preventing delayed emesis in this patient?", "options": [{"label": "A", "text": "Dronabinol", "correct": false}, {"label": "B", "text": "Domperidone", "correct": false}, {"label": "C", "text": "Dexamethasone", "correct": false}, {"label": "D", "text": "Aprepitant", "correct": true}], "correct_answer": "D. Aprepitant", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:799px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5-HT</strong><strong><sub>3</sub></strong><strong> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ondansetron (shortest-acting, weak 5-HT<sub>4</sub> antagonist)</li>\n<li><strong>Palonosetron</strong> (longest-acting + most potent)</li>\n<li><strong>Granisetron </strong>(can be given intradermal)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting\n\t\t\t\t<ul>\n<li>Early onset: Ondansetron</li>\n<li>Late onset: Palonosetron</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Headache</li>\n<li><strong>QT prolongation</strong>\n<ul>\n<li>Maximum: <strong>Dolasetron</strong></li>\n<li>Minimum: <strong>Palonosetron</strong></li>\n</ul>\n</li>\n<li>Hypotension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Centrally acting D2 antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Metoclopramide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n<li>Gastroparesis.</li>\n<li>Paralytic ileus.</li>\n<li>Bowel cleansing.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Extra-pyramidal symptoms (acute dystonia).</li>\n<li>Severe hyperprolactinemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Domperidone<br/>\n<strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild-moderate vomiting.</li>\n<li>GERD.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Minor EPS features.</li>\n<li>Mild hyperprolactinema.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neurokinin-1 inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Aprepitant</li>\n<li>Fosaprepitant</li>\n<li>Rolapitant</li>\n<li>Netupitant</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Late-onset <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (DOC)</strong></li>\n<li>Post-operative <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rolapitant:\n\t\t\t\t<ul>\n<li>Neutropenia.</li>\n<li>Hiccups.</li>\n<li>Decreased appetite.</li>\n<li>Dizziness.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cannabinoids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dronabinol<br/>\n<strong>(Option A)</strong></li>\n<li>Nabilone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> <strong>(refractory cases).</strong></li>\n<li><strong>Appetite stimulant</strong> (can be used in <strong>HIV</strong> and <strong>anorexia</strong> patients.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypotension.</li>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> <strong>(bloodshot eyes)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antihistamines</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cyclizine</li>\n<li>Meclizine</li>\n<li>Promethazine</li>\n<li>Diphenhydramine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motion sickness</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sedation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Doxylamine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Morning <span class=\"customMeta\" data-dictid=\"73c1caf8d11692777198b1248373d3\">sickness</span> (given with <strong>pyridoxine</strong>)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dry mouth</li>\n<li>Drowsiness</li>\n<li>Dry mouth</li>\n<li>Constipation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Muscarinic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hyoscine (scopolamine)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motion <span class=\"customMeta\" data-dictid=\"73c1caf8d11692777198b1248373d3\">sickness</span> (<strong>DOC</strong>, available as a <strong>transdermal patch</strong>)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dry mouth.</li>\n<li>Visual disturbances.</li>\n<li>Drowsiness.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Glucocorticoids (Option D)</strong> (dexamethasone) are used as an <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> in the management of chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting.</li>\n<li>M/C used drugs for delayed <span class=\"customMeta\" data-dictid=\"f7f955e4b0169277718686e55870bc\">emesis</span> associated with cancer chemotherapy: <strong>Ondansetron (5-HT</strong><strong><sub>3</sub> antagonist) + Aprepritant (NK-1 inhibitor) + Dexamethasone.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0C17iWYZRLJoA1tIZvuk1745664147.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "In paracetamol poisoning, N-acetylcysteine is administered as an antidote. How does it act to prevent toxicity?", "options": [{"label": "A", "text": "Inhibits the toxin", "correct": false}, {"label": "B", "text": "Removes the toxin", "correct": false}, {"label": "C", "text": "Restores glutathione levels", "correct": true}, {"label": "D", "text": "Neutralizes liver enzymes", "correct": false}], "correct_answer": "C. Restores glutathione levels", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management of <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">Paracetamol</span> poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Gastric Lavage</strong></li>\n<li>Administer <span class=\"customMeta\" data-dictid=\"5dd23480451692777180e299cc38bc\">activated charcoal</span> or <span class=\"customMeta\" data-dictid=\"8cbc9195731692777184663e492746\">cholestyramine</span> (effective within 30 minutes of ingestion)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>N-acetylcysteine (NAC) Therapy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Initiate within <strong>8 hours</strong> of ingestion; may be partially effective up to <strong>24–36 hours</strong> post-overdose.</li>\n<li><strong>Administration</strong>:</li>\n</ul>\n<ul>\n<li>IV: 140 mg/kg <span class=\"customMeta\" data-dictid=\"00a5dcc74b16927771913b344e36a3\">loading</span> dose over 1 hour, followed by 70 mg/kg every 4 hours for 15–20 doses.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>NAC acts as a <span class=\"customMeta\" data-dictid=\"1a1b98a5d7169277719914104ae697\">sulfhydryl</span> donor, replenishing glutathione.</li>\n<li>Neutralizes toxic metabolites and prevents binding to cell proteins, reducing the severity of <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> necrosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Liver Transplantation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Considered in cases of <strong>hepatic failure</strong> (jaundice, coagulopathy, confusion).</li>\n<li><strong>King's College Criteria</strong> is used to predict the need for a liver transplant in patients with paracetamol-induced <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> liver failure :</li>\n</ul>\n<ul>\n<li>Arterial blood pH &lt; 7.30</li>\n</ul>\n<p>Or all of the following:</p>\n<ul>\n<li>Prothrombin time (PT) &gt; 100 seconds (INR &gt; 6.5)</li>\n<li>Serum <span class=\"customMeta\" data-dictid=\"2ead0fd0301692777185187bd72768\">creatinine</span> &gt; 300 μmol/L</li>\n<li>Grade III or IV <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> encephalopathy.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the treatment of Zollinger-Ellison syndrome?", "options": [{"label": "A", "text": "Cimetidine", "correct": false}, {"label": "B", "text": "Omeprazole", "correct": true}, {"label": "C", "text": "Misoprostol", "correct": false}, {"label": "D", "text": "Aluminium hydroxide", "correct": false}], "correct_answer": "B. Omeprazole", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Omeprazole&lt;br/&gt;\n&lt;br/&gt;\nE\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Proton pump inhibitor suppresses gastric acid secretion by acting on?", "options": [{"label": "A", "text": "H+/Cl- ATPase pump", "correct": false}, {"label": "B", "text": "H+/K+ ATPase pump", "correct": true}, {"label": "C", "text": "Na+/K+ ATPase pump", "correct": false}, {"label": "D", "text": "Na+/K+/Cl- ATPase pump", "correct": false}], "correct_answer": "B. H+/K+ ATPase pump", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Proton pump inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It inhibits the <strong>H+/K+ ATPase pump </strong>located in the <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells of the stomach, thus reducing acid <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> in the stomach.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Potency of PPI</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rabeprazole &gt; Lansoprazole &gt; Rabeprazole &gt; Omeprazole &gt; Pantoprazole</li>\n<li>All PPIs have equal efficacy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Properties </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Acid production reduction persists for 2 to 4 days even after stopping the drug and resumes later.</li>\n<li>Duration of action is typically 2 to 4 days.\n\t\t\t\t<ul>\n<li>Omeprazole is the fastest acting PPI.</li>\n<li>PPIs are acid labile; Enteric coating can protect from acid degradation.</li>\n<li>They should be taken on an empty stomach when only ~I0% of <span class=\"customMeta\" data-dictid=\"9c823198d61692777196bc71097d6d\">proton</span> pumps are active, followed 1 hour later by a meal to <span class=\"customMeta\" data-dictid=\"dddc752e1716927771807f985bb8bb\">activate</span> the H+/K+/ATPase at a time when <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration of the <span class=\"customMeta\" data-dictid=\"6d17c6d6f1169277719687447037f2\">PPI</span> is maximal.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chronic use of PPIs can lead to hypergastrinemia, which can further result in:\n\t\t\t\t<ul>\n<li>ECL hyperplasia</li>\n<li>Fundic <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> polyposis</li>\n<li>Atrophic gastritis</li>\n</ul>\n</li>\n<li>Gastrointestinal upset (nausea, constipation, diarrhoea)</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"04f4b6dbf71692777192ca0c4f70fa\">microbial</span> growth leads to a higher risk of bacterial infection</li>\n<li>Increased risk of bone fractures due to <span class=\"customMeta\" data-dictid=\"59f10ee7c31692777189a8544bb404\">hypocalcemia</span> (reduced <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> of calcium)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a prokinetic?", "options": [{"label": "A", "text": "5-HT4 agonist", "correct": false}, {"label": "B", "text": "Dopamine antagonist", "correct": false}, {"label": "C", "text": "Motilin agonist", "correct": false}, {"label": "D", "text": "Diphenylmethane", "correct": true}], "correct_answer": "D. Diphenylmethane", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Diphenylmethane</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Prokinetic</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prokinetic agents are medications that enhance <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">motility</span> and promote the movement of food through the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> tract.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>5-HT<sub>4</sub> agonist</strong> - stimulates 5-HT<sub>4</sub> in the GIT, which causes increased release of <span class=\"customMeta\" data-dictid=\"a79a62c36e169277718062f9630d56\">Acetylcholine</span> and enhances GIT motility</p>\n<ul>\n<li><strong>Naronapride</strong></li>\n<li><strong>Cisapride </strong></li>\n<li><strong>Prucalopride </strong></li>\n</ul>\n<p><strong>Dopamine <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> - </strong>blocks <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> receptors in the GIT, which reduces the <span class=\"customMeta\" data-dictid=\"1b6bd49bf11692777190214aa47f99\">inhibitory</span> effects of <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">dopamine</span> on the GIT motility.</p>\n<ul>\n<li><strong>Metocloprimde </strong></li>\n<li><strong>Domperidone </strong></li>\n</ul>\n<p><strong>Motilin <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> - </strong> Mimics the action of motilin, which promotes GIT motility</p>\n<ul>\n<li><strong>Erythromycin </strong>(Off-label)</li>\n<li><strong>Camicinal</strong></li>\n</ul>\n<p><strong>Miscellaneous </strong></p>\n<ul>\n<li><strong>Sincalide</strong> - <span class=\"customMeta\" data-dictid=\"f64846f7ea16927771835e864b62e7\">C-terminal</span> <span class=\"customMeta\" data-dictid=\"16c05c3596169277719419d79fd5e8\">octapeptide</span> of CCK</li>\n<li><strong>Relamorelin</strong> - <span class=\"customMeta\" data-dictid=\"fd5e44e39e16927771889e55274ff1\">Ghrelin</span> agonist</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Gastrointestinal <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> disease</li>\n<li>Gastroparesis</li>\n<li>Functional dyspepsia</li>\n<li>Postoperative ileus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Gastrointestinal <span class=\"customMeta\" data-dictid=\"4586eccbe71692777186e577e31829\">disturbance</span> (Diarrhoea, Vomiting, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> cramps)</li>\n<li>Headache</li>\n<li>Dizziness</li>\n<li>Extrapyramidal symptoms with <span class=\"customMeta\" data-dictid=\"9194a239ed1692777186bfe41c0e87\">Dopamine</span> antagonist</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is used for the treatment of motion sickness?", "options": [{"label": "A", "text": "Cetirizine", "correct": false}, {"label": "B", "text": "Promethazine", "correct": true}, {"label": "C", "text": "Misolastin", "correct": false}, {"label": "D", "text": "Loratidine", "correct": false}], "correct_answer": "B. Promethazine", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/BIlBIr93cEIpaSIJSYyT1746435875.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Drug </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Promethazine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Antihistamine with <span class=\"customMeta\" data-dictid=\"b676cf039416927771814f87114511\">antiemetic</span> action</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drowsiness, dry mouth, blurred vision</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dimenhydrinate </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>An <span class=\"customMeta\" data-dictid=\"b934c33cc21692777181f55e558ff3\">antihistamine</span> with <span class=\"customMeta\" data-dictid=\"9b4dbbb3321692777181e6fe172b88\">anticholinergic</span> properties</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drowsiness, dry mouth, blurred vision, constipation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Meclizine </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Scopolamine </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anticholinergic with <span class=\"customMeta\" data-dictid=\"b676cf039416927771814f87114511\">antiemetic</span> action</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drowsiness, dry mouth, blurred vision</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Drugs for motion sickness</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anticholinergics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Scopolamine</strong></p>\n<ul>\n<li>\n<ul>\n<li>Used as a <span class=\"customMeta\" data-dictid=\"48982b740216927772004a198271cd\">transdermal</span> patch,</li>\n<li>Use 4 to 5 hours before travel.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Antihistamines</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diphenhydramine</strong>, <strong>Promethazine</strong>, and <strong>Meclizine</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most frequently observed adverse effect of orlistat among the options provided?", "options": [{"label": "A", "text": "Acute kidney injury", "correct": false}, {"label": "B", "text": "Osteoporosis", "correct": false}, {"label": "C", "text": "Steatorrhea", "correct": true}, {"label": "D", "text": "Colorectal cancer", "correct": false}], "correct_answer": "C. Steatorrhea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Steatorrh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A tourist with a travel history to India presents with complaints of abdominal pain and multiple episodes of watery diarrhea. He reports having food at a local restaurant the previous night. Which of the following antidiarrheal agents is used in this condition?", "options": [{"label": "A", "text": "Octreotide", "correct": false}, {"label": "B", "text": "Loperamide", "correct": true}, {"label": "C", "text": "Rifaximin", "correct": false}, {"label": "D", "text": "Bismuth subsalicylate", "correct": false}], "correct_answer": "B. Loperamide", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is most appropriate to be used for the treatment of diarrhea in a patient who was treated for colorectal carcinoma with 5-fluorouracil?", "options": [{"label": "A", "text": "Ciprofloxacin", "correct": false}, {"label": "B", "text": "Loperamide", "correct": true}, {"label": "C", "text": "Atropine", "correct": false}, {"label": "D", "text": "Ornidazole", "correct": false}], "correct_answer": "B. Loperamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - L\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A colonoscopy of an elderly patient revealed brownish-pigmented lesions. The patient admitted to chronic laxative abuse. Which of the following laxatives is most likely to cause this condition?", "options": [{"label": "A", "text": "Bran", "correct": false}, {"label": "B", "text": "Psyllium", "correct": false}, {"label": "C", "text": "Senna", "correct": true}, {"label": "D", "text": "Methylcellulose", "correct": false}], "correct_answer": "C. Senna", "question_images": ["https://image.prepladder.com/content/8f7zQYOHk7v5TokxHokd1745309230.png"], "explanation_images": [], "explanation": "<p>Correct Answer C - S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 12-year-old boy presents with complaints of profuse, watery stools and an elevated WBC count of 16000 cells/mm3. He has been on treatment with amoxicillin for the past 1 week. What is the treatment of choice for his condition?", "options": [{"label": "A", "text": "Metronidazole", "correct": false}, {"label": "B", "text": "Fidaxomicin", "correct": true}, {"label": "C", "text": "Ciprofloxacin", "correct": false}, {"label": "D", "text": "Bezlotoxumab", "correct": false}], "correct_answer": "B. Fidaxomicin", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs which increase the risk of Pseudomembranous colitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs useful in Pseudomembranous colitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Clindamycin</li>\n<li>Cephalosporins (e.g., ceftriaxone)</li>\n<li>Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)</li>\n<li>Penicillins (e.g., ampicillin, amoxicillin)</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metronidazole</li>\n<li>Vancomycin</li>\n<li>Fidaxomicin</li>\n<li>Rifaximin</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was started on antitubercular therapy. After 10 days, investigations were done. AST and ALT levels were within normal limits but serum creatinine is 0.9 mg/dL and serum uric acid was 10 mg/dL. The patient also complains of diffuse joint pains. What is the next best step in management?", "options": [{"label": "A", "text": "Stop pyrazinamide and continue isoniazid, rifampicin, and ethambutol.", "correct": true}, {"label": "B", "text": "Add allopurinol and stop isoniazid, continuing other ATT drugs with monitoring.", "correct": false}, {"label": "C", "text": "Continue all ATT drugs and start high-dose corticosteroids for joint pains.", "correct": false}, {"label": "D", "text": "Stop ethambutol and continue other ATT drugs with uric acid monitoring.", "correct": false}], "correct_answer": "A. Stop pyrazinamide and continue isoniazid, rifampicin, and ethambutol.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the drug of choice (DOC) for treating morning sickness in pregnant women?", "options": [{"label": "A", "text": "Pyridoxine (Vitamin B6)", "correct": true}, {"label": "B", "text": "Domperidone", "correct": false}, {"label": "C", "text": "Ondansetron", "correct": false}, {"label": "D", "text": "Metoclopramide", "correct": false}], "correct_answer": "A. Pyridoxine (Vitamin B6)", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is used in GERD?", "options": [{"label": "A", "text": "Ondansetron", "correct": false}, {"label": "B", "text": "Domperidone", "correct": true}, {"label": "C", "text": "Loperamide", "correct": false}, {"label": "D", "text": "Diphenoxylate", "correct": false}], "correct_answer": "B. Domperidone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient underwent gastrointestinal surgery and had her jejunum resected. Which of the following drugs should be added to her treatment?", "options": [{"label": "A", "text": "Liraglutide", "correct": false}, {"label": "B", "text": "Teduglutide", "correct": true}, {"label": "C", "text": "Exenatide", "correct": false}, {"label": "D", "text": "Semaglutide", "correct": false}], "correct_answer": "B. Teduglutide", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Teduglutide</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Peptide hormone (GLP-2 <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> )</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Teduglutide ⟶ Binds to <strong>GLP-2 Receptors</strong> on Intestinal epithelial cells ⟶ Activation of Guanylate Cyclase ⟶ Increased production of cGMP ⟶ Activation of Protein Kinase G⟶ Regulation of Tight Junctions and Epithelial transporters ⟶ Enhanced intestinal <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> of fluid and nutrients ⟶ Improved <span class=\"customMeta\" data-dictid=\"b5f500def916927771888b49285ac6\">glycemic</span> control.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Treatment of <strong>short <span class=\"customMeta\" data-dictid=\"37863e7aec169277718310f33c6a11\">bowel</span> syndrome (SBS) </strong>in adult patients who are dependent on <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> support.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Benefits</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reduces <span class=\"customMeta\" data-dictid=\"01be542e8e16927771861e861ab536\">dependence</span> on <span class=\"customMeta\" data-dictid=\"f4eacdbe7b1692777194d7caa2017d\">parenteral</span> nutrition</li>\n<li>Improves intestinal <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> and transit time</li>\n<li>Increases nutrient <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> and fluid balance</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Nausea and Vomiting</li>\n<li>Headache</li>\n<li>Upper <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> infection</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Gastrointestinal <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> or perforation</li>\n<li>Gastrointestinal cancer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Special Points</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Requires <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> injection</li>\n<li>Dosing and adjustment should be based on individual patient responses.</li>\n<li>Regular monitoring of nutritional status and <span class=\"customMeta\" data-dictid=\"98d46770fc1692777202253fb59fe9\">fluid balance</span> is essential.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most appropriate treatment for a patient presenting with diarrhea and a flask-shaped ulcer on a colonoscopy?", "options": [{"label": "A", "text": "Metronidazole", "correct": true}, {"label": "B", "text": "Ciprofloxacin", "correct": false}, {"label": "C", "text": "Vancomycin", "correct": false}, {"label": "D", "text": "Ampicillin", "correct": false}], "correct_answer": "A. Metronidazole", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Tissue Amebicidal Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Metronidazole</strong></p>\n<p> </p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ol>\n<li><strong>DOC for all forms of amebiasis</strong></li>\n<li>Treats <span class=\"customMeta\" data-dictid=\"6000beebf41692777181fb008e4936\">amebic colitis</span> and liver abscess</li>\n<li><strong>Penetrates well into body tissues and fluids, </strong>including <span class=\"customMeta\" data-dictid=\"9a1e50b8221692777201b95b66c9de\">vaginal</span> secretions, seminal fluid, saliva, breast milk, and <span class=\"customMeta\" data-dictid=\"99a9bf133e1692777184ec4b1011fe\">cerebrospinal</span> fluid.</li>\n</ol>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ol>\n<li>Effective against Entamoeba histolytica trophozoites but less effective against cysts.</li>\n<li><strong>Inhibits protein <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in Entamoeba</strong></li>\n<li>Treats giardiasis, trichomoniasis, and <span class=\"customMeta\" data-dictid=\"4880fc99551692777181e25a64560f\">anaerobic</span> infections</li>\n<li>Used in combination therapy for H. pylori infection</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Tinidazole</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p><strong>Amebic <span class=\"customMeta\" data-dictid=\"e6955110f21692777184d2090a400c\">colitis</span> and liver abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>Also used to treat <strong>Trichomoniasis.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Ornidazole</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p><strong>Acute amoebic dysentery</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Secnidazole</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Emetine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>Acute amoebic <span class=\"customMeta\" data-dictid=\"83b2863439169277718675fa3b9b00\">dysentery</span> or <strong>amoebic liver <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> in patients not tolerating metronidazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ul>\n<li>Directly acting amoebicide that kills trophozoites but has no effect on cysts.</li>\n<li><strong>Side effects include <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> and cardiotoxicity.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Chloroquine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p><strong>Amoebic liver abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>Kills the liver stage of <em>Entamoeba histolytica</em></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Luminal Amebicidal Drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p style=\"text-align:center\"><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p style=\"text-align:center\"><strong>Additional points &amp; S/E</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none; vertical-align:top\">\n<p><strong>Paromomycin</strong></p>\n<p><strong>(DOC)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>An Aminoglycoside</p>\n<p><strong>Luminal agent for amebiasis.</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>An <strong>alternative drug for Giardiasis</strong>, especially in the first <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy where <span class=\"customMeta\" data-dictid=\"452c41e7811692777192cd0d89fdc7\">metronidazole</span> is C/I.</p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Diloxanide furoate</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p><strong>Mild intestinal amebiasis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>Furoate is the active <span class=\"customMeta\" data-dictid=\"708d2a81e4169277719263f5f17227\">moiety</span> that kills <em>Entamoeba</em></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Quiniodochlor</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>Rarely used due to dangerous <strong>side effects such as SMON</strong> (Subacute myelo-optico-neuropathy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Iodoquinol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p><strong>Contains <span class=\"customMeta\" data-dictid=\"58c4fcb71116927771901e83ac026f\">iodine</span> and can cause <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> abnormalities</strong> and allergy</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Luminal Amebicidal Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:1px solid #333438; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Tissue Amebicidal Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none; vertical-align:top\">\n<ul>\n<li>Paromomycin</li>\n<li>Diloxanide furoate</li>\n<li>Quiniodochlor</li>\n<li>Iodoquinol</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none; vertical-align:top\">\n<ul>\n<li>Metronidazole or its congeners (Tinidazole, Ornidazole)</li>\n<li>Emetine</li>\n<li>Chloroquine</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Diphenoxylate is used to treat secretory diarrhea, and it is often combined with atropine. What is the primary reason for this combination therapy?", "options": [{"label": "A", "text": "To correct the side effects of diphenoxylate", "correct": false}, {"label": "B", "text": "To enhance the antidiarrheal efficacy of diphenoxylate", "correct": false}, {"label": "C", "text": "To provide an additional antidiarrheal effect", "correct": false}, {"label": "D", "text": "To reduce the potential for abuse of diphenoxylate", "correct": true}], "correct_answer": "D. To reduce the potential for abuse of diphenoxylate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - To reduce the potential for abuse of diph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old woman presents to the emergency department 6 hours after ingesting a large quantity of paracetamol tablets. What is the most likely progression of paracetamol poisoning in this case?", "options": [{"label": "A", "text": "Increase in liver enzymes within 24 hours", "correct": true}, {"label": "B", "text": "Liver failure within 24 hours", "correct": false}, {"label": "C", "text": "Paracetamol achieves peak concentration within 4 hours", "correct": false}, {"label": "D", "text": "Recovery within 72 hours", "correct": false}], "correct_answer": "A. Increase in liver enzymes within 24 hours", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolism of Acetaminophen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acetaminophen is mainly metabolized via <strong>phase II</strong> reactions into harmless<strong> sulfate</strong> and <strong>glucuronide</strong> metabolites.</li>\n<li>A small portion undergoes<strong> phase I </strong>metabolism by<strong> CYP2E1</strong>, forming the <span class=\"customMeta\" data-dictid=\"aad52f4a541692777188bfd2c5830b\">hepatotoxic</span> <span class=\"customMeta\" data-dictid=\"fceb6bf8d01692777192b8b179f554\">metabolite</span> <strong>N-acetyl-p-benzoquinone-imine (NAPQI)</strong>.</li>\n</ul>\n<p><strong>Detoxification of NAPQI</strong></p>\n<ul>\n<li>NAPQI is neutralized by binding to glutathione, forming water-soluble mercapturic acid, which is excreted via the kidneys.</li>\n</ul>\n<p><strong>Glutathione Depletion</strong></p>\n<ul>\n<li>When excessive NAPQI is produced, or <span class=\"customMeta\" data-dictid=\"f945849e691692777188ad7ce5b5e2\">glutathione</span> is depleted, NAPQI binds to <span class=\"customMeta\" data-dictid=\"d92a2c1a2f1692777188848354f32b\">hepatocyte</span> macromolecules, forming acetaminophen-protein adducts, causing <span class=\"customMeta\" data-dictid=\"d92a2c1a2f1692777188848354f32b\">hepatocyte</span> necrosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic alcohol use (induces CYP2E1, depletes glutathione).</li>\n<li>Starvation.</li>\n<li>Prior use of mixed-function oxidase-inducing drugs (e.g.,<strong> phenobarbital</strong>, <strong>INH</strong>).</li>\n<li><strong>Hepatitis C</strong> infection increases the risk of liver injury in overdose.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early Symptoms (4-12 hrs)</strong>:</p>\n<ul>\n<li>Nausea, vomiting, diarrhea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain, shock.</li>\n</ul>\n<p><strong>Delayed Symptoms (24-48 hrs)</strong>:</p>\n<ul>\n<li>Hepatic injury becomes apparent.</li>\n<li>Coagulopathy and encephalopathy.</li>\n<li>Maximal damage seen 3–5 days post-ingestion with <span class=\"customMeta\" data-dictid=\"c011dc417616927771816fef085ce1\">aminotransferase</span> levels &gt;10,000 IU/L.</li>\n<li>Renal failure and myocardial injury may occur.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stages of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"95b7c54ee116927771809963c4ee14\">acetaminophen</span> poisoning</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Time Post-Ingestion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0–24 hours</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nausea, vomiting, and anorexia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>24–72 hours</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Right upper <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> pain; elevated liver enzymes (AST, ALT), and sometimes increased <span class=\"customMeta\" data-dictid=\"2d60c5a677169277718325a811dcf1\">bilirubin</span> and INR if <span class=\"customMeta\" data-dictid=\"072b8af16e1692777196f21b086f92\">poisoning</span> is severe.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>72–96 hours</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vomiting, signs of liver failure; peak levels of AST, ALT, bilirubin, and INR. Possible <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure and pancreatitis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IV</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>&gt; 5 days</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recovery of liver function or <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> to multiple organ failure.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Prucalopride is a ___________:", "options": [{"label": "A", "text": "5HT2a agonist", "correct": false}, {"label": "B", "text": "5HT2b agonist", "correct": false}, {"label": "C", "text": "5HT4 antagonist", "correct": false}, {"label": "D", "text": "5HT4 agonist", "correct": true}], "correct_answer": "D. 5HT4 agonist", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - 5HT4 ag\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is not used in treatment in Wilson’s disease ?", "options": [{"label": "A", "text": "Zinc", "correct": false}, {"label": "B", "text": "Penicillamine", "correct": false}, {"label": "C", "text": "Calcium citrate", "correct": true}, {"label": "D", "text": "Trientine", "correct": false}], "correct_answer": "C. Calcium citrate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Calciu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A pediatric patient was prescribed erythromycin for the prevention of recurrent rheumatic fever in a rural health center . If the patient complained of a history of constipation , which medication should be avoided to prevent the development of any arrhythmia?", "options": [{"label": "A", "text": "Lubiprostone", "correct": false}, {"label": "B", "text": "Streptomycin", "correct": false}, {"label": "C", "text": "Ebastine", "correct": false}, {"label": "D", "text": "Cisapride", "correct": true}], "correct_answer": "D. Cisapride", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Most effective antiemetic for chemotherapy–induced vomiting is _____________.", "options": [{"label": "A", "text": "Domperidone", "correct": false}, {"label": "B", "text": "Tegaserod", "correct": false}, {"label": "C", "text": "Granisetron", "correct": true}, {"label": "D", "text": "Doxylamine", "correct": false}], "correct_answer": "C. Granisetron", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - G\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True statement about teduglutide is :", "options": [{"label": "A", "text": "It is a GLP-2 analogue", "correct": true}, {"label": "B", "text": "It’s half life is 6-8 hours", "correct": false}, {"label": "C", "text": "It is administered orally", "correct": false}, {"label": "D", "text": "It is recommended for patients with colorectal cancer", "correct": false}], "correct_answer": "A. It is a GLP-2 analogue", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - It is a GLP-2 analogu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A colonoscopy of an elderly patient revealed brownish pigmented lesions as shown below. He admitted to chronic laxative abuse. Which of the following laxatives is most likely to cause this condition?", "options": [{"label": "A", "text": "Bran", "correct": false}, {"label": "B", "text": "Psylium", "correct": false}, {"label": "C", "text": "Senna", "correct": true}, {"label": "D", "text": "Methylcellulose", "correct": false}], "correct_answer": "C. Senna", "question_images": ["https://image.prepladder.com/content/cK998W7kpzF2RXfhUNgM1715854985.PNG"], "explanation_images": [], "explanation": "<p>Correct Option C - S\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions can be treated with pirenzepine?", "options": [{"label": "A", "text": "Asthma", "correct": false}, {"label": "B", "text": "Peptic ulcer disease", "correct": true}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Hypertension", "correct": false}], "correct_answer": "B. Peptic ulcer disease", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"f6768ff15f1692777195a493cad3a9\"&gt;Peptic&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\"&gt;ulcer&lt;/span&g\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug Class</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Proton Pump Inhibitors (PPIs)</p>\n</td>\n<td>\n<p>Omeprazole, Esomeprazole, Lansoprazole</p>\n</td>\n<td>\n<p>Inhibit the <span class=\"customMeta\" data-dictid=\"9c823198d61692777196bc71097d6d\">proton</span> pump (H<sup>+</sup>/K<sup>+</sup> ATPase) in <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells, reducing acid <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> and promoting <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> healing.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Histamine H2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonists</p>\n</td>\n<td>\n<p>Ranitidine, Famotidine, Cimetidine</p>\n</td>\n<td>\n<p>Block the <span class=\"customMeta\" data-dictid=\"b5d4ddbfe71692777189a12acd5502\">histamine</span> H2 receptors on <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells, reducing acid <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> and promoting <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> healing.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antacids</p>\n</td>\n<td>\n<p>Aluminum hydroxide, <span class=\"customMeta\" data-dictid=\"4d7ed0baae169277719199f6e9ab7b\">Magnesium</span> hydroxide</p>\n</td>\n<td>\n<p>Neutralize <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> acid, providing temporary relief from symptoms and promoting <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> healing.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Mucosal Protective Agents</p>\n</td>\n<td>\n<p>Sucralfate, Misoprostol</p>\n</td>\n<td>\n<p>Enhance mucosal defense mechanisms, promote mucosal healing, and reduce acid secretion.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Antibiotics</p>\n</td>\n<td>\n<p>Amoxicillin, Clarithromycin, Metronidazole</p>\n</td>\n<td>\n<p>Used in combination therapy to eradicate <span class=\"customMeta\" data-dictid=\"313a9372811692777188be2ca0dedc\">Helicobacter</span> pylori infection, which is associated with <span class=\"customMeta\" data-dictid=\"f6768ff15f1692777195a493cad3a9\">peptic</span> ulcers.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>M1 Blockers</p>\n</td>\n<td>\n<p>Pirenzepine, Telenzepine</p>\n</td>\n<td>\n<p>Selectively block <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> M1 receptors in the <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> cells, reducing acid <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> and promoting <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> healing.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old female comes to the OPD for well-care visits. The patient is completely well and eats a balanced diet . She never smokes or drinks alcohol and has no significant past medical history . On examination, her vitals are normal. The patient tells the physician that next week she will go on a trip to an island and is worried about motion sickness . Which of the following drugs may be considered first-line therapy for this patient's prophylaxis of motion sickness?", "options": [{"label": "A", "text": "Promethazine", "correct": true}, {"label": "B", "text": "Ondansetron", "correct": false}, {"label": "C", "text": "Metoclopramide", "correct": false}, {"label": "D", "text": "Domperidone", "correct": false}], "correct_answer": "A. Promethazine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Prometh\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Anti-Emetic</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Conditions </strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Promethazine</strong></p>\n</td>\n<td>\n<p>Motion sickness, <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), vertigo</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Ondansetron</strong></p>\n</td>\n<td>\n<p>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), radiation-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting, gastroenteritis</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Metoclopramide</strong></p>\n</td>\n<td>\n<p>Gastroparesis, chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), <span class=\"customMeta\" data-dictid=\"9f47bfb9a616927771887db45c89c7\">gastroesophageal</span> <span class=\"customMeta\" data-dictid=\"def94cc96d16927771970d1a5cfb71\">reflux</span> disease (GERD)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Domperidone</strong></p>\n</td>\n<td>\n<p>Gastroparesis, <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), GERD</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Prochlorperazine</strong></p>\n</td>\n<td>\n<p>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), vertigo, migraine-associated <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Dimenhydrinate</strong></p>\n</td>\n<td>\n<p>Motion sickness, vertigo, <span class=\"customMeta\" data-dictid=\"e8b3c606051692777201faf2a1a357\">vestibular</span> disorders</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Scopolamine</strong></p>\n</td>\n<td>\n<p>Motion sickness, <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Aprepitant</strong></p>\n</td>\n<td>\n<p>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Dexamethasone</strong></p>\n</td>\n<td>\n<p>Chemotherapy-induced <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (CINV), <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and <span class=\"customMeta\" data-dictid=\"998fb41ebc1692777202e46891c4a7\">vomiting</span> (PONV), <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> severe <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">nausea</span> and vomiting</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is the recommended temperature for drugs which need to be stored in a refrigerator but not in the freezer ?", "options": [{"label": "A", "text": "1-7°C", "correct": false}, {"label": "B", "text": "2-8°C", "correct": true}, {"label": "C", "text": "4-12°C", "correct": false}, {"label": "D", "text": "7-15°C", "correct": false}], "correct_answer": "B. 2-8°C", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Bgc91KByc5AEO5Dvzjdp1747068921.mp3", "video": ""}, {"text": "Arrange the following steps in the correct order as they occur in the process of drug development: Filing of an Investigational New Drug (IND) application. Start toxicity and safety testing based on GLP guidelines. Approval from Central Drugs Standard Control Organization (CDSCO). Start pharmacokinetics and pharmacodynamics testing based on GCP guidelines. Filing of an NDA application to CDSCO. Approval from the Committee for Control and Supervision of Experiments on Animals (CPCSEA)", "options": [{"label": "A", "text": "6, 2, 1, 4, 3, 5", "correct": true}, {"label": "B", "text": "6, 2, 4, 1, 3, 5", "correct": false}, {"label": "C", "text": "3, 2, 6, 1, 4, 5", "correct": false}, {"label": "D", "text": "6, 2, 1, 4, 5, 3", "correct": false}], "correct_answer": "A. 6, 2, 1, 4, 3, 5", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dANYHIQnfVdBYE9f54gy1747066750.mp3", "video": ""}, {"text": "Which of the following statements is true regarding the source of a drug?", "options": [{"label": "A", "text": "Atropine and vaccines are developed through rational drug design.", "correct": false}, {"label": "B", "text": "HIT refers to a synthetic chemical with the potential to become a drug.", "correct": true}, {"label": "C", "text": "Preclinical trials are not necessary for potential medications.", "correct": false}, {"label": "D", "text": "The most common way to find a potential drug is by high throughput screening of all available chemicals.", "correct": false}], "correct_answer": "B. HIT refers to a synthetic chemical with the potential to become a drug.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Natural </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>High throughput screening</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Rational drug designing</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Plants: Morphine, <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">atropine</span> <strong>(Option A)</strong></li>\n<li>Animals: Vaccines, <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> antibody</li>\n<li>Microorganism: Penicillin, streptomycin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Screening all available chemicals with the potential to become a drug is the M/C way. <strong>(Option D)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Developed to bind at target receptors</li>\n<li>E.g. PPIs.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uVsEPWCEGyMpOAkBP8L91747066987.mp3", "video": ""}, {"text": "Match the phases of drug trials with their correct descriptions: Phase Description 1. Phase 0 a. Determines drug efficacy and side effects on a heterogeneous population 2. Phase 1 b. Monitor long-term side effects and drug interaction in hidden populations. 3. Phase 2 c. Human testing to assess drug safety and maximum tolerable dose (MDT). 4. Phase 3 d. Randomized trials to assess drug efficacy and optimal dosing 5. Phase 4 e: Low dosing trials to check drug-target binding.", "options": [{"label": "A", "text": "1: e, 2: c, 3: d, 4: a, 5: b", "correct": true}, {"label": "B", "text": "1: c, 2: e, 3: a, 4: b, 5: a", "correct": false}, {"label": "C", "text": "1: e, 2: c, 3: a, 4: b, 5: d", "correct": false}, {"label": "D", "text": "1: c, 2: d, 3: e, 4: a, 5: b", "correct": false}], "correct_answer": "A. 1: e, 2: c, 3: d, 4: a, 5: b", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:654px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\"><strong>Phases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\">Phase 0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Design: An open-label trial</li>\n<li>Purpose: \n\t\t\t\t<ul>\n<li><strong>Check the target binding of a drug</strong></li>\n<li>Check the <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> of the drug</li>\n</ul>\n</li>\n<li>Called a micro-dosing trial (100 micrograms dose)</li>\n<li>Non-mandatory clinical trial</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\">Phase 1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Design: An open-label trial</li>\n<li>Purpose: \n\t\t\t\t<ul>\n<li>Evaluate drug safety- the most important</li>\n<li><strong>Evaluate <span class=\"customMeta\" data-dictid=\"0762a5fb2d1692777193f06aa57615\">MTD</span> (maximum tolerable dose)</strong>, <span class=\"customMeta\" data-dictid=\"00a5dcc74b16927771913b344e36a3\">loading</span> dose and drug half-life.</li>\n<li>Evaluate drug <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> (absorption, distribution, <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and excretion)</li>\n</ul>\n</li>\n<li>Called the first human trial </li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\">Phase 2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Design: <strong>Randomized clinical trial</strong> (RCT)</li>\n<li>Purpose: \n\t\t\t\t<ul>\n<li><strong>Explore drug efficacy</strong></li>\n</ul>\n</li>\n<li>Called a <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> exploratory trial or proof of concept trial</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\">Phase 3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Design: Double-blinded RCT </li>\n<li>Purpose: \n\t\t\t\t<ul>\n<li>Find the <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> drug dose</li>\n<li><strong>Confirm efficacy</strong></li>\n<li>Safety is priority</li>\n</ul>\n</li>\n<li>Called a <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> confirmatory trial </li>\n<li>Called multi-site trial (done on a <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> population)</li>\n<li>Drugs get market approval</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:76px\">\n<p style=\"text-align:center\">Phase 4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:548px\">\n<ul>\n<li>Design: Open-label</li>\n<li>Purpose: \n\t\t\t\t<ul>\n<li>Find hidden/missed/rare adverse effects. </li>\n<li>Evaluate compliance: <strong>long-term side effects</strong></li>\n<li><strong>Drug interactions</strong></li>\n<li>Food interactions</li>\n</ul>\n</li>\n<li>Called post-marketing surveillance </li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nWX2klnFPT4KSIGQQOgM1747067254.mp3", "video": ""}, {"text": "Match the phases of clinical trials with their target populations: Phase Target Population 1. Phase 0 a. Patients with the disease of interest 2. Phase 1 b. General patient population post-marketing 3. Phase 2 c. Healthy volunteers 4. Phase 3 d. Small number of patients with the disease 5. Phase 4 e. Very small number of healthy or diseased individuals", "options": [{"label": "A", "text": "1: b, 2: c, 3: d, 4: e, 5: a", "correct": false}, {"label": "B", "text": "1: e, 2: c, 3: d, 4: a, 5: b", "correct": true}, {"label": "C", "text": "1: a, 2: d, 3: c, 4: e, 5: b", "correct": false}, {"label": "D", "text": "1: e, 2: c, 3: a, 4: b, 5: d", "correct": false}], "correct_answer": "B. 1: e, 2: c, 3: d, 4: a, 5: b", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:600px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Number of Volunteers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of population</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phase 0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2-5</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Healthy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phase 1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20-50</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Healthy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phase 2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>200-500</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Patients</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phase 3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2000-5000</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Patients</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phase 4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Larger population (cannot be predicted)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Patients on the approved drug</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VzVzgK47nq04pDZp5jED1747067560.mp3", "video": ""}, {"text": "A 68-year-old female on Digoxin presents to the emergency department with symptoms of nausea, vomiting, blurred vision, and severe bradycardia indicative of Digoxin toxicity. She was given antidote DIGIBIND. Which of the following categories does this specific antidote belong?", "options": [{"label": "A", "text": "Counterfeit drugs", "correct": false}, {"label": "B", "text": "Essential drugs", "correct": false}, {"label": "C", "text": "Orphan drugs", "correct": true}, {"label": "D", "text": "Over-the-counter drugs", "correct": false}], "correct_answer": "C. Orphan drugs", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:484px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Desferrioxamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clofazimine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sodium stibogluconate</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digibind</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Colchicine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sodium thiosulfate</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fomepizole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Eltrombopag</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sodium nitrite</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Felbamate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fomivirsen</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ThioTEPA</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenosine deaminase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Icatibant</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Succimer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Azacitidine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nilotinib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rifabutin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bevacizumab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Paromomycin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Somatropin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bortezomib</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rifaximin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Liothyronine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carboprost</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rituximab</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Miltefosine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8RkPvA4bK5lpEY0j2Rja1747067823.mp3", "video": ""}, {"text": "Which of the following statements are true about counterfeit drugs? Counterfeit drugs may contain incorrect ingredients. These drugs often have the same therapeutic effect as genuine drugs. Counterfeit drugs are usually subject to rigorous quality control. They can lead to treatment failure and contribute to drug resistance. Counterfeit drugs may be labelled with fake packaging to resemble genuine products.", "options": [{"label": "A", "text": "1, 2, and 4", "correct": false}, {"label": "B", "text": "1, 3, and 5", "correct": false}, {"label": "C", "text": "1, 4, and 5", "correct": true}, {"label": "D", "text": "2, 3, and 5", "correct": false}], "correct_answer": "C. 1, 4, and 5", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:690px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Spurious Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Have no active ingredient</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>500 mg <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> <span class=\"customMeta\" data-dictid=\"508e14a7ca16927772002140ece8fb\">tablet</span> → when checked, it contains no <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> in it.</li>\n<li>Made by illegal people other than the manufacturer to copy the drug.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Misbranded Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Low-quality drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>500 mg <span class=\"customMeta\" data-dictid=\"508e14a7ca16927772002140ece8fb\">tablet</span> → when checked, it contains only 200 mg.</li>\n<li>Made by the same manufacturer to increase profit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Adulterated Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Addition of harmful or unwanted excipients</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>Cough <span class=\"customMeta\" data-dictid=\"7cab9109cd16927771994c3125bd23\">syrup</span> made in India containing <span class=\"customMeta\" data-dictid=\"8e2fdef08316927771877389af9cc7\">ethylene</span> <span class=\"customMeta\" data-dictid=\"7451dcad4f1692777188609e12be1d\">glycol</span> → when checked, <span class=\"customMeta\" data-dictid=\"20fced1d1f1692777188cf8c607e50\">GMP</span> guidelines do not approve these substances.</li>\n<li>Ethylene <span class=\"customMeta\" data-dictid=\"7451dcad4f1692777188609e12be1d\">glycol</span> is harmful and not approved as an <span class=\"customMeta\" data-dictid=\"0925b97d4d16927771873ae9dcd02c\">excipient</span> by GMP.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RnZWJ8NXC9u3WsAtKXsP1747068080.mp3", "video": ""}, {"text": "A 28-year-old pregnant woman comes to the antenatal clinic for regular check up. An ultrasound of her abdomen showed craniofacial abnormalities, hypoplasia of the phalanges, and cleft palate. Which of the following medications is most likely to cause this condition?", "options": [{"label": "A", "text": "Valproate", "correct": false}, {"label": "B", "text": "Phenytoin", "correct": true}, {"label": "C", "text": "Isotretinoin", "correct": false}, {"label": "D", "text": "Warfarin", "correct": false}], "correct_answer": "B. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Teratogenic Disorder</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Acitretin</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Craniofacial anomalies</strong>, heart defects, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Alcohol</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Fetal Alcohol Syndrome </strong>(growth retardation, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> anomalies, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> dysfunction, ASD, VSD).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>ACE inhibitors &amp; Angiotensin-receptor blockers</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Renal dysgenesis, oligohydramnios</strong>, lung hypoplasia, skull hypoplasia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Carbamazepine</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Neural tube defects </strong>(spina bifida), <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Isotretinoin (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Craniofacial anomalies, heart defects, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Lithium</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Ebstein's <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> </strong>(tricuspid <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> malformation).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Thalidomide</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Severe limb defects <strong>(phocomelia)</strong>, ear, cardiac, and <span class=\"customMeta\" data-dictid=\"2fd33fb2ac16927771889901daadeb\">genitourinary</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Carbimazole &amp; methimazole</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Choanal atresia</strong>, <span class=\"customMeta\" data-dictid=\"5dff4943631692777181b8974b302b\">aplasia</span> cutis, and <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> goitre.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Penicillamine</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Cutis laxa syndrome</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Statins</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Vertebral, anal, cardiac, tracheo-oesophageal fistula, renal, arterial, and limb defects (VACTERAL defects).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>SSRIs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Persistent <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> of the newborn.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Valproic acid (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Neural tube defects (spina bifida),</strong> <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> malformations, and developmental delay.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Warfarin</strong> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Fetal <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> syndrome: <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> hypoplasia, <span class=\"customMeta\" data-dictid=\"3d7836b47f1692777199a5bbfc749f\">stippled</span> epiphyses, limb hypoplasia, and central nervous system abnormalities.</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xXUrmE3vQNx2jkCbAXjI1747068245.mp3", "video": ""}, {"text": "Which of the following is the primary aim of pharmacovigilance?", "options": [{"label": "A", "text": "To conduct clinical trials for new drugs", "correct": false}, {"label": "B", "text": "To ensure the quality and efficacy of pharmaceutical products", "correct": false}, {"label": "C", "text": "To reduce the risk of drug-related harm to the patient", "correct": true}, {"label": "D", "text": "To control the marketing and distribution of medications", "correct": false}], "correct_answer": "C. To reduce the risk of drug-related harm to the patient", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Component</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse Drug Reactions (ADR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Monitoring and managing harmful effects caused by drugs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post-Marketing Surveillance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Continuous monitoring of drugs' safety profile after approval.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signal Detection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Identifying new potential risks associated with a drug.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Strategies to minimize risks associated with the use of drugs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Regulatory Actions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves recommendations for changing labels, withdrawal, or restricting use based on findings.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QNJw8XOwLccm9z2h5ecA1747068348.mp3", "video": ""}, {"text": "All of the following are true about Placebo drugs except:", "options": [{"label": "A", "text": "It is used as a dummy medication", "correct": false}, {"label": "B", "text": "It contains the active moiety", "correct": true}, {"label": "C", "text": "It can induce physiological responses", "correct": false}, {"label": "D", "text": "Placebo helps in blinding", "correct": false}], "correct_answer": "B. It contains the active moiety", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wQag45CxcY8yzjN9rfib1747068530.mp3", "video": ""}, {"text": "A diabetic patient on regular insulin therapy accidentally injects himself with a higher dose than prescribed. He experiences sweating, trembling, confusion, and dizziness. Which type of adverse drug reaction (ADR) can be seen in this patient?", "options": [{"label": "A", "text": "Type A", "correct": true}, {"label": "B", "text": "Type B", "correct": false}, {"label": "C", "text": "Type C", "correct": false}, {"label": "D", "text": "Type D", "correct": false}], "correct_answer": "A. Type A", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:681px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of reaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong>ugmented</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dose-dependent, predictable, and more common.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↑ <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> → hypoglycemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B</strong>izzare</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dose-independent, non-predictable, less common, and more serious.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allergy &amp; idiosyncracy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>hronic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dose &amp; duration dependent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Suppression of hypothalamic-pituitary <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> by chronic <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> use.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>D</strong>elayed</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Duration dependent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Kidney disease from long-term <span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\">NSAID</span> use.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>E</strong>nd of use</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Withdrawal symptoms</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Opioid withdrawal.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>F</strong>ailure</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Failure of therapy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enzyme inducers → OCP failure.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YGC25m00lgOWKZ2FwCFJ1747068640.mp3", "video": ""}, {"text": "A patient who was admitted with acute myocardial infarction is due for discharge. His previous medical records show a defective CYP2C19. Which of his following long-term medications should be avoided in this case?", "options": [{"label": "A", "text": "Ticagrelor", "correct": false}, {"label": "B", "text": "Ramipril", "correct": false}, {"label": "C", "text": "Clopidogrel", "correct": true}, {"label": "D", "text": "Atenolol", "correct": false}], "correct_answer": "C. Clopidogrel", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:587px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacogenetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacogenomics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The study of the genetic basis for <span class=\"customMeta\" data-dictid=\"128186f064169277720116e786798a\">variability</span> in drug response.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It uses genetic information to guide the choice of drug and dose individually.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It deals with genetic influences on drug action as well as on drug handling of the body.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It tends to identify individuals who are either more likely or less likely to respond to a drug, as well as those who require altered doses of certain drugs.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/w6yA4gu66W031L6WSM8p1747068788.mp3", "video": ""}, {"text": "Match the following adverse reactions with their causative agents. Image Drug Responsible Sulfonamides Carbamazepine Tetracyclines Griseofulvin", "options": [{"label": "A", "text": "1-a, 2-d, 3-b, 4-c", "correct": false}, {"label": "B", "text": "1-c, 2-b, 3-a, 4-d", "correct": true}, {"label": "C", "text": "1-b, 2-c, 3-d, 4-a", "correct": false}, {"label": "D", "text": "1-d, 2-b, 3-d, 4-c", "correct": false}], "correct_answer": "B. 1-c, 2-b, 3-a, 4-d", "question_images": ["https://image.prepladder.com/content/5b0pDD3TPtL8KT909zd51736344461.png", "https://image.prepladder.com/content/pJ2BmEzpC7DXPDoCgfdn1736344524.png", "https://image.prepladder.com/content/vH4LoYkcHNGXy55IL1Nx1736344602.png", "https://image.prepladder.com/content/89sq3e9DhtHshemuV01z1736344663.png"], "explanation_images": ["https://image.prepladder.com/content/J7Dy7dSxNEdCrjH8Uv5U1736344742.png", "https://image.prepladder.com/content/zwD3wIK0OOvRBHOEBQhn1736344813.png", "https://image.prepladder.com/content/jEq4jjSyu4jDsZbirx2e1736344886.png", "https://image.prepladder.com/content/IaPivSKFURmQN6rdAIyr1736344943.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/c0nNEiskO2ItXCUSc7rT1745660173.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 23 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following agents inhibits the action of an agonist on a receptor or the subsequent response but does not have any effect of its own?", "options": [{"label": "A", "text": "Drug A", "correct": false}, {"label": "B", "text": "Drug B", "correct": false}, {"label": "C", "text": "Drug C", "correct": true}, {"label": "D", "text": "Drug D", "correct": false}], "correct_answer": "C. Drug C", "question_images": ["https://image.prepladder.com/content/kI9yIzcpvQdZDXxu2gyK1736529110.png"], "explanation_images": ["https://image.prepladder.com/content/Ro8iu1htReMCgPjaWjk01736529160.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:208px\">\n<p><strong>Drug C </strong><strong>(Option C)</strong><strong>:</strong><strong> </strong><strong>Antagonist</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:416px\">\n<ul>\n<li>It prevents the <strong>action of an agonist</strong> on a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> or the subsequent response but <strong>does not have any effect of its own. </strong></li>\n<li>Naloxone, an <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist, is commonly used to reverse <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> overdose.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:208px\">\n<p><strong>Drug A </strong><strong>(Option A)</strong><strong>:</strong><strong> </strong><strong>Agonist</strong></p>\n<p><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:416px\">\n<ul>\n<li>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to <strong>produce an effect similar to the <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> signal molecule</strong><strong> </strong>(e.g., <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">morphine</span> at <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:208px\">\n<p><strong>Drug D </strong><strong>(Option D)</strong><strong>:</strong><strong> </strong><strong>Inverse Agonist</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:416px\">\n<ul>\n<li>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to<strong> produce an effect opposite</strong> to that of an <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> (e.g., Rimonabant at <span class=\"customMeta\" data-dictid=\"fe04fe7edd169277718355bcc41507\">cannabinoid</span> receptors).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:208px\">\n<p><strong>Drug B </strong><strong>(Option B)</strong><strong>: Partial Agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:416px\">\n<ul>\n<li>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to produce a <strong>submaximal effect</strong> and can block the action of a <strong>full agonist</strong><strong> </strong>(e.g., <span class=\"customMeta\" data-dictid=\"b15fb72c3c16927771837d01fe5d28\">Buprenorphine</span> at <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> receptors).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:208px\">\n<p><strong>Super Agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:416px\">\n<ul>\n<li>Not directly relevant to <span class=\"customMeta\" data-dictid=\"e22dbf6c52169277719441ac94a69e\">opioid</span> <span class=\"customMeta\" data-dictid=\"3f4eecb1c6169277719459c801fb19\">overdose</span> treatment but <strong>produces a maximum response greater than that of the <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> agonist</strong><strong> </strong>(e.g., BMS-986121 at GLP-1 receptors).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/P9wyr4ceiDNER25mjXCh1747034730.mp3", "video": ""}, {"text": "A patient with an overdose of a toxic substance is treated with a drug that directly binds to and inactivates the toxic substance. Which type of antagonist is being used in this treatment?", "options": [{"label": "A", "text": "Physical Antagonist", "correct": false}, {"label": "B", "text": "Physiological Antagonist", "correct": false}, {"label": "C", "text": "Chemical Antagonist", "correct": true}, {"label": "D", "text": "Pharmacological Antagonist", "correct": false}], "correct_answer": "C. Chemical Antagonist", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Antagonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chemical <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">Antagonist</span> </strong><strong>(Option C):</strong></p>\n<p>Direct interaction between two drugs to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> an inactive product.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>KMnO4 and Alkaloids:</strong> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">Potassium</span> <span class=\"customMeta\" data-dictid=\"4cf8c99df91692777195e2a1907a39\">permanganate</span> oxidises alkaloids and is used in <strong>gastric lavage</strong> for poisoning.</li>\n<li><strong>Tannins and Alkaloids:</strong> Tannins react with alkaloids to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> <span class=\"customMeta\" data-dictid=\"5d21b8a47c16927771906f7f0e2590\">insoluble</span> alkaloidal tannate.</li>\n<li><strong>Chelating Agents (BAL, <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> <span class=\"customMeta\" data-dictid=\"c4be0f188216927771868a0e7cbe2b\">Disodium</span> EDTA): </strong>These agents are complex with toxic metals like arsenic (As) and lead (Pb).</li>\n<li><strong>Nitrites and Cyanide:</strong> Nitrites <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> methemoglobin, which reacts with <span class=\"customMeta\" data-dictid=\"2cf30efe831692777185e200487656\">cyanide</span> radicals.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Physical <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">Antagonist</span> </strong><strong>(Option A)</strong></p>\n<p>Physical methods are used to counteract the effects of a substance, often not involving <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> interactions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Activated <span class=\"customMeta\" data-dictid=\"e7626b047e169277718484971217b8\">charcoal</span> is used to physically <span class=\"customMeta\" data-dictid=\"1228502b9d1692777180d52d2ce776\">adsorb</span> toxins in the <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> to prevent their absorption.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Physiological <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">Antagonist</span> </strong><strong>(Option B)</strong></p>\n<p>Involves two agents that produce opposite effects on the same <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> function without interacting directly with each other or the same receptor.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Insulin and <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">glucagon</span> are <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> antagonists. <span class=\"customMeta\" data-dictid=\"b47c9c6144169277719010eaa1a0ee\">Insulin</span> lowers blood <span class=\"customMeta\" data-dictid=\"af3ae60c0c16927771889b84ca41c0\">glucose</span> levels, while <span class=\"customMeta\" data-dictid=\"c4d90ebfde1692777188e3689c1753\">glucagon</span> raises them.</li>\n<li>Histamine and <span class=\"customMeta\" data-dictid=\"35b6a8aeb416927771805fcc2e7dfb\">adrenaline</span> on bronchial muscles and blood pressure.</li>\n<li>Hydrochlorothiazide and amiloride on <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> excretion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacological Antagonist(Option D)</strong></p>\n<p>Drugs acting on the same <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> as the <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> but producing 0 overall effects and preventing the action of <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> on receptor.<br/>\n\t\t\t </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Morphine and naloxone</li>\n<li>Acetylcholine and atropine</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/elsSGEYcIqdmS4eOVPsB1747034810.mp3", "video": ""}, {"text": "Which type of antagonist acts on different receptors or mechanisms to produce opposite effects on the same physiological function?", "options": [{"label": "A", "text": "Competitive antagonist", "correct": false}, {"label": "B", "text": "Non-competitive antagonist", "correct": false}, {"label": "C", "text": "Physiological antagonist", "correct": true}, {"label": "D", "text": "Inverse agonist", "correct": false}], "correct_answer": "C. Physiological antagonist", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:149px\">\n<p><strong>Type of Antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:172px\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:174px\">\n<p><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:149px\">\n<p><strong>Competitive Antagonist</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:172px\">\n<p>Competes with agonists for the same binding site, reducing the <span class=\"customMeta\" data-dictid=\"2a93f2d9a11692777196928bd78855\">potency</span> of the agonist.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px\">\n<p><strong>Reversible</strong> binding to the same <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> site as the agonist.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:174px\">\n<p>Propranolol (β-blocker) binds to β-adrenergic receptors, reducing the effect of adrenaline(β-agonist)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:149px\">\n<p><strong>Non-Competitive Antagonist </strong></p>\n<p><strong>(Option B)</strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:172px\">\n<p>Prevents the action of an <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> without competing with it for the binding site.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px\">\n<p><strong>Irreversible </strong>binding to the <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> reduces the maximum effect of the agonist.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:174px\">\n<p>Phenoxybenzamine binds to α-adrenergic receptors, reducing the effect of adrenaline.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:149px\">\n<p><strong>Physiological Antagonist</strong><strong> </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:172px\">\n<p>Acts on different receptors or mechanisms to produce opposite effects on the same <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> function.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px\">\n<p>Does not directly interact with the same <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> or <span class=\"customMeta\" data-dictid=\"f9016f36fd1692777198b0fd5e9c6d\">signaling</span> <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">pathway</span> as the agonist.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:174px\">\n<p>Calcium channel <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> reduces the effect of <span class=\"customMeta\" data-dictid=\"35b6a8aeb416927771805fcc2e7dfb\">adrenaline</span> on the heart.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:149px\">\n<p><strong>Inverse Agonist</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:172px\">\n<p>Selectively binds to the inactive <span class=\"customMeta\" data-dictid=\"c6d0a6443d16927771840860d28dfb\">conformation</span> of a constitutively active receptor, reducing the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> activity of the receptor.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:165px\">\n<p>Binds to the inactive <span class=\"customMeta\" data-dictid=\"c6d0a6443d16927771840860d28dfb\">conformation</span> of the receptor, reducing the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> activity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top; width:174px\">\n<p>Propranolol (β-blocker) can act as an <span class=\"customMeta\" data-dictid=\"459918ac4616927771903ea16da4c9\">inverse</span> <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> on β-adrenergic receptors, reducing the <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> activity of the receptor.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eoZcI3ezSp8WDnRQXhPa1747034932.mp3", "video": ""}, {"text": "In a pharmacology experiment, you observe that adding a competitive antagonist increases the EC50 without changing the maximum response. Adding a non-competitive antagonist decreases the maximum response without changing the EC50. Which of the following best describes the dose-response curve changes for these scenarios?", "options": [{"label": "A", "text": "Competitive antagonist shifts left, non-competitive antagonist shifts down.", "correct": false}, {"label": "B", "text": "Competitive antagonist shifts right, and non-competitive antagonist shifts down.", "correct": true}, {"label": "C", "text": "Competitive antagonist shifts down, and non-competitive antagonist shifts right.", "correct": false}, {"label": "D", "text": "Competitive antagonist shifts right, non-competitive antagonist shifts left.", "correct": false}], "correct_answer": "B. Competitive antagonist shifts right, and non-competitive antagonist shifts down.", "question_images": ["https://image.prepladder.com/content/BUieiJJNOXQPPh7jQjMV1736529713.png"], "explanation_images": ["https://image.prepladder.com/content/eZFLntbgWza6FAbltVXh1736529554.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Competitive Antagonism</strong><strong> </strong><strong> </strong><strong> </strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Competitive Antagonism</strong><strong> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong><strong> </strong><strong> </strong><strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competes with agonists for the same <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> site</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to a different site on the receptor, alters <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> function</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on Dose-Response Curve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Shifts to the right, no change in <span class=\"customMeta\" data-dictid=\"c678bddb1d1692777192d2ee1ebd92\">maximal</span> response</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flattens the curve, reduces the <span class=\"customMeta\" data-dictid=\"c678bddb1d1692777192d2ee1ebd92\">maximal</span> response</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reversibility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reversible</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Irreversible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Maximal Response</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unaffected</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduced</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effective Concentration for 50% of population/ EC50 (Km)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreased</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unchanged</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cFRZgen1ZUC0WFXkrvwo1747035199.mp3", "video": ""}, {"text": "Identify the correct statement based on the following Michaelis-Menten graph showing the effect of different types of inhibitors on a reaction.", "options": [{"label": "A", "text": "B denotes competitive inhibition", "correct": false}, {"label": "B", "text": "C denotes non-competitive inhibition", "correct": false}, {"label": "C", "text": "Vmax is directly proportional to the enzyme concentration", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": ["https://image.prepladder.com/content/xlrrdsPfZ4DkDE91savV1736529848.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>COMPETITIVE INHIBITOR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>NON-COMPETITIVE INHIBITOR</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uncompetitive inhibitior</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Substrate resemblance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Resembles substrate.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It does not resemble the substrate.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It does not resemble the substrate.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on increasing [S]</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition can be reversed.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition cannot be reversed.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition can be reversed.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Binding site</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Active site.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allosteric site.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enzyme <span class=\"customMeta\" data-dictid=\"385d52533a169277719991c090c3d7\">substrate</span> complex</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vmax</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unchanged. </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Decreases (as active <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> decreases). </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Decreases (as active <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> decreases).</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Km</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases (more <span class=\"customMeta\" data-dictid=\"385d52533a169277719991c090c3d7\">substrate</span> needed to overcome inhibited enzyme).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unchanged (increasing <span class=\"customMeta\" data-dictid=\"385d52533a169277719991c090c3d7\">substrate</span> does not overcome the inhibition).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases (more <span class=\"customMeta\" data-dictid=\"385d52533a169277719991c090c3d7\">substrate</span> needed to overcome inhibited enzyme).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nI0jwks3He5MhMzjNlB31747035504.mp3", "video": ""}, {"text": "A clinical trial of 4 new drugs was conducted, and the following graphs were obtained. Based on these graphs, which of the following statements is/are correct? a) Drug A has the highest efficacy as well as the highest potency. b) Drug A has the highest efficacy but the lowest potency. c) Drug D has the highest efficacy as well as the highest potency. d) Drug B is more potent than drug C.", "options": [{"label": "A", "text": "Statements a and d are correct", "correct": true}, {"label": "B", "text": "Statements b and d are correct", "correct": false}, {"label": "C", "text": "Only statement b is correct", "correct": false}, {"label": "D", "text": "None of the statements are correct", "correct": false}], "correct_answer": "A. Statements a and d are correct", "question_images": ["https://image.prepladder.com/content/pgHAmA8c7FBOQD2zkGVx1736529942.png"], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zJXes4WjAMQIDVRIe82J1748859899.mp3", "video": ""}, {"text": "Which of the following statements is true about dose-response curves (DRCs)?", "options": [{"label": "A", "text": "Graded DRCs measure the all-or-none response to different drug doses within a population.", "correct": false}, {"label": "B", "text": "Quantal DRCs plot the response to a drug continuously within an individual.", "correct": false}, {"label": "C", "text": "U-shaped DRCs are rare and can indicate toxicity at both low and high doses.", "correct": true}, {"label": "D", "text": "Graded DRCs are used to calculate the median effective dose (ED50) and the median lethal dose (LD50) in a population.", "correct": false}], "correct_answer": "C. U-shaped DRCs are rare and can indicate toxicity at both low and high doses.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/WIPFJ1A9bxEJvVZcsiNj1736530036.png", "https://image.prepladder.com/content/KOJ9lNKuenPH459GSjNt1736530154.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Drug /hormone/vitamin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Deficiency </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Excess </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Insulin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diabetes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypoglycemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Iron</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hemochromatosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitamin A</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Night blindness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Liver damage, blurred vision.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1I3n9XWuYVJr6voZCSpv1747066220.mp3", "video": ""}, {"text": "Lithium was prescribed to a newly diagnosed patient with bipolar disorder. Frequent monitoring is needed while using Lithium as it has a lower therapeutic index. How is the therapeutic index of a drug calculated?", "options": [{"label": "A", "text": "The ratio between the median toxic dose and median effective dose of lithium in the population.", "correct": true}, {"label": "B", "text": "The ratio between the median effective dose and median toxic dose of lithium in the population.", "correct": false}, {"label": "C", "text": "Product of median effective dose and median toxic dose of lithium.", "correct": false}, {"label": "D", "text": "Average of the sum of the median effective dose and median toxic dose of lithium.", "correct": false}], "correct_answer": "A. The ratio between the median toxic dose and median effective dose of lithium in the population.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/RfoSzh7d1XDgDWdK39LH1736530436.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:509px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>TI= <span class=\"customMeta\" data-dictid=\"979385c98a1692777192fb1721a16e\">median</span> <strong>toxic dose</strong>/median <strong>effective dose</strong> ; (TD50/ED50)</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NWppDtWy5yC7Yf4Ic3X61747066335.mp3", "video": ""}, {"text": "A 35-year-old man with a history of epilepsy presents for a medication review. He has been taking phenytoin for the past year and wants to ensure his medication dosage is appropriate. Which of the following is the therapeutic range of phenytoin?", "options": [{"label": "A", "text": "10-20 mcg/ml", "correct": true}, {"label": "B", "text": "40-50 mcg/ml", "correct": false}, {"label": "C", "text": "50-100 mcg/ml", "correct": false}, {"label": "D", "text": "100-120 mcg/ml", "correct": false}], "correct_answer": "A. 10-20 mcg/ml", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/nSKWtxluOOb6jDPPCxWj1736530541.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rwiBixhflKgSHlZ64xsG1747066462.mp3", "video": ""}, {"text": "A 65-year-old man with a history of chronic heart failure presents for a follow-up appointment. He has been on digoxin therapy for several years. During the consultation, the cardiologist discusses the importance of therapeutic drug monitoring (TDM) to ensure optimal digoxin levels for effective treatment. TDM is NOT done in which of the following?", "options": [{"label": "A", "text": "Detect drug levels in case of poisoning levels.", "correct": false}, {"label": "B", "text": "Use of aminoglycosides in patients with renal failure.", "correct": false}, {"label": "C", "text": "Drugs with a narrow therapeutic index.", "correct": false}, {"label": "D", "text": "Drugs with irreversible action.", "correct": true}], "correct_answer": "D. Drugs with irreversible action.", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LAcElou6ZVclwEVKiWtW1747036265.mp3", "video": ""}, {"text": "Which of the following types of receptors is the fastest acting?", "options": [{"label": "A", "text": "Enzyme-linked receptors", "correct": false}, {"label": "B", "text": "G-protein coupled receptors", "correct": false}, {"label": "C", "text": "Intracellular receptors", "correct": false}, {"label": "D", "text": "Ligand-gated ion channel receptors", "correct": true}], "correct_answer": "D. Ligand-gated ion channel receptors", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KOQ9b0rNrmEnJqm2rLaV1736531999.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Na: Excitatory</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cl: Inhibitory</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nicotinic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (acetylcholine)</li>\n<li>5HT3 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (serotonin)</li>\n<li>NMDA <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> (glutamate)</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>GABA - Cl Channel</li>\n<li>Glycine - Cl Channel</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mVhEhJ0nzl1ULi0XTq4L1747036411.mp3", "video": ""}, {"text": "Which is the active subunit of G-protein coupled receptors (GPCR)?", "options": [{"label": "A", "text": "Alpha subunit (ɑ)", "correct": true}, {"label": "B", "text": "Beta subunit (β)", "correct": false}, {"label": "C", "text": "Gamma subunit (ɣ)", "correct": false}, {"label": "D", "text": "Delta subunit (δ)", "correct": false}], "correct_answer": "A. Alpha subunit (ɑ)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/jDpteEiWMoUOx6W550vn1736532094.png", "https://image.prepladder.com/content/LoBFcyetVkyzOYH45PiN1724259253.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3jkBoP58jUQl6cs2BwrL1747036571.mp3", "video": ""}, {"text": "Which second messenger is associated with phospholipase C (PLC) activation by Gq protein?", "options": [{"label": "A", "text": "Cyclic AMP (cAMP)", "correct": false}, {"label": "B", "text": "Inositol trisphosphate (IP3) and diacylglycerol (DAG)", "correct": true}, {"label": "C", "text": "Cyclic GMP (cGMP)", "correct": false}, {"label": "D", "text": "Nitric oxide (NO)", "correct": false}], "correct_answer": "B. Inositol trisphosphate (IP3) and diacylglycerol (DAG)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/APQRyRI5LleyQ6U4AApz1736532253.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n\t\t\t \n\n\t\t\t<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G Protein Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effector</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second Messenger(s)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclic <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases cAMP, activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gi</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases cAMP, inhibits protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phospholipase C (PLC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inositol trisphosphate (IP3) and DAG</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IP3 releases Ca2+ from ER; <span class=\"customMeta\" data-dictid=\"ffd1412fed1692777185cd107f3835\">DAG</span> activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> C (PKC)</p>\n</td>\n</tr>\n</tbody>\n</table>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G Protein Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effector</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second Messenger(s)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclic <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases cAMP, activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gi</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases cAMP, inhibits protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phospholipase C (PLC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inositol trisphosphate (IP3) and DAG</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IP3 releases Ca2+ from ER; <span class=\"customMeta\" data-dictid=\"ffd1412fed1692777185cd107f3835\">DAG</span> activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> C (PKC)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6xAd9vbRZWRrxOtFoz2I1747036720.mp3", "video": ""}, {"text": "When bound to its receptor, which ligand activates Gs proteins, leading to increased adenylyl cyclase activity and elevated cAMP levels?", "options": [{"label": "A", "text": "Serotonin at 5-HT1 receptors", "correct": false}, {"label": "B", "text": "Glucagon", "correct": true}, {"label": "C", "text": "Somatostatin", "correct": false}, {"label": "D", "text": "Thromboxane", "correct": false}], "correct_answer": "B. Glucagon", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:407px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protein</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ligands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptors</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagon</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagon receptor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Epinephrine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>β-adrenergic receptors (β1, β2, β3)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Histamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H₂ receptors</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gi</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetylcholine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscarinic M2 receptors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dopamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D₂ receptors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Serotonin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-HT₁ receptors</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gq</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Serotonin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-HT₂ receptors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetylcholine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Muscarinic M1 receptors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Histamine</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H₁ receptors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thromboxane</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>TP receptors</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ligand</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G-protein Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on cAMP</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glucagon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucagon receptor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↑ Activates <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> <span class=\"customMeta\" data-dictid=\"b638747a661692777185a6182d6e5f\">cyclase</span> ↑</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Serotonin <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-HT₁ receptor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gi</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ Inhibits <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> cyclase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Somatostatin <strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Somatostatin receptor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gi</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ Inhibits <span class=\"customMeta\" data-dictid=\"7112e9ca411692777180a7c10a13a6\">adenylyl</span> cyclase</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thromboxane <strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>TP receptor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq (mainly)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activates <span class=\"customMeta\" data-dictid=\"b3c0aa468916927771955a8c6d6998\">phospholipase</span> C (↑IP₃/DAG), not cAMP</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/w6HWznLd2np39BVf955M1747036899.mp3", "video": ""}, {"text": "Which of the following acts on enzyme-linked receptors?", "options": [{"label": "A", "text": "Epinephrine", "correct": false}, {"label": "B", "text": "Insulin", "correct": true}, {"label": "C", "text": "Acetylcholine", "correct": false}, {"label": "D", "text": "Dopamine", "correct": false}], "correct_answer": "B. Insulin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:596px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">Kinase</span> Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ligands</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Receptor Tyrosine Kinases (RTKs)</li>\n<li>Receptor Serine/Threonine Kinases</li>\n<li>Cytokine Receptors (JAK-STAT pathway)</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Insulin, <span class=\"customMeta\" data-dictid=\"616d85c57416927771875ef23f6751\">Epidermal</span> Growth Factor (EGF)</li>\n<li>Transforming Growth Factor-beta (TGF-β)</li>\n<li>Growth Hormone, <span class=\"customMeta\" data-dictid=\"ec50ec51401692777187009530441d\">Erythropoietin</span> (EPO)</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oN4C1EQw7mgb3xRlIWhi1747037001.mp3", "video": ""}, {"text": "Which statement is not true about intracellular receptors?", "options": [{"label": "A", "text": "Intracytoplasmic receptors are attached to heat shock proteins (HSP) when inactive.", "correct": false}, {"label": "B", "text": "Intracellular receptors interact with lipid-soluble ligands that can pass through the cell membrane.", "correct": false}, {"label": "C", "text": "Intracellular receptors typically require second messengers to relay the signal inside the cell.", "correct": true}, {"label": "D", "text": "They interact with co-activators or co-repressors in the nucleus", "correct": false}], "correct_answer": "C. Intracellular receptors typically require second messengers to relay the signal inside the cell.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:648px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intranuclear Receptors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intracytoplasmic Receptors</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Thyroid Receptors</li>\n<li>Retinoic Acid Receptors</li>\n<li>PPAR</li>\n<li>Estrogen Receptors</li>\n</ul>\n</td>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Glucocorticoid Receptors</li>\n<li>Mineralocorticoid Receptors</li>\n<li>Androgen Receptors</li>\n<li>Progesterone Receptors</li>\n<li>Calcitriol Receptors</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/n0yjvcDYbVCAwda9cUcq1747037217.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 26 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs is not metabolised by the CYP2C19 enzyme?", "options": [{"label": "A", "text": "Clopidogrel", "correct": false}, {"label": "B", "text": "Omeprazole", "correct": false}, {"label": "C", "text": "Voriconazole", "correct": false}, {"label": "D", "text": "Warfarin", "correct": true}], "correct_answer": "D. Warfarin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5HEhiVmdPLD3G6mJ87ty1727010046.mp3", "video": ""}, {"text": "Which of the following is true about the elimination kinetics of phenytoin?", "options": [{"label": "A", "text": "The rate of elimination is proportional to plasma concentration", "correct": false}, {"label": "B", "text": "Half-life remains constant irrespective of plasma concentration", "correct": false}, {"label": "C", "text": "The clearance is independent of plasma concentration throughout", "correct": false}, {"label": "D", "text": "Kinetics changes from first order to zero order at higher doses", "correct": true}], "correct_answer": "D. Kinetics changes from first order to zero order at higher doses", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BBjlFV1LfQ3JubUr9WPz1747034511.mp3", "video": ""}, {"text": "A patient is given a 300 mg dose of a drug. After 1 hour, 75 mg of the drug is excreted. Assuming the drug is eliminated from the system by following first-order kinetics, how much of the drug will remain after 4 hours of starting the drug?", "options": [{"label": "A", "text": "72 mg", "correct": false}, {"label": "B", "text": "94 mg", "correct": true}, {"label": "C", "text": "122 mg", "correct": false}, {"label": "D", "text": "148 mg", "correct": false}], "correct_answer": "B. 94 mg", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5rhrI5VsdLI1dIo8bTCP1747034346.mp3", "video": ""}, {"text": "A drug given to a patient is known to follow a capacity-limited elimination pattern. Which of the following is incorrect about this mode of drug elimination?", "options": [{"label": "A", "text": "The amount of the drug eliminated per unit of time will remain constant", "correct": false}, {"label": "B", "text": "Clearance of the drug will be less at higher concentrations.", "correct": false}, {"label": "C", "text": "The half-life of the drug will be longer at lower concentrations", "correct": true}, {"label": "D", "text": "The rate of elimination of the drug is independent of plasma concentration.", "correct": false}], "correct_answer": "C. The half-life of the drug will be longer at lower concentrations", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/eXDgA3v4ZTKOZlXmL42t1736534832.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>First-order kinetics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Zero-order kinetics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Description</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <strong>constant fraction</strong> of the drug is eliminated per unit of time.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <strong>constant amount</strong> of the drug is eliminated per unit of time.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rate of clearance</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Constant</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More at lower concentrations and less at higher concentrations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Half-life</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Constant</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less at lower concentrations and more at higher concentrations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rate of elimination</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Proportional to its <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Independent of <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Examples</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most of the drugs.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alcohol, aspirin, theophylline, tolbutamide, and warfarin.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/g4bIPRmv2YTKjcKC6MnD1747034165.mp3", "video": ""}, {"text": "The target concentration of a drug given to a patient should be 5 mg/L. Assuming the drug's bioavailability is 0.5 and it gets cleared out of the system at a rate of 2L/hr, what is the maintenance dose to be given twice daily?", "options": [{"label": "A", "text": "190 mg", "correct": false}, {"label": "B", "text": "240 mg", "correct": true}, {"label": "C", "text": "300 mg", "correct": false}, {"label": "D", "text": "330 mg", "correct": false}], "correct_answer": "B. 240 mg", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/AyGDV29aRAh1Y5L9uxQH1747118376.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MFI46NVCjqFaofj1hw2T1727010966.mp3", "video": ""}, {"text": "A 70 kg patient is administered 2 mg of warfarin. If its plasma concentration is 200 mcg/L, calculate the apparent volume of distribution of the drug.", "options": [{"label": "A", "text": "0.25 L/kg", "correct": false}, {"label": "B", "text": "0.10 L/kg", "correct": false}, {"label": "C", "text": "0.15 L/kg", "correct": true}, {"label": "D", "text": "0.20 L/kg", "correct": false}], "correct_answer": "C. 0.15 L/kg", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong><strong><sub>d</sub></strong><strong> = Dose of drug administered/plasma concentration</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Low V</strong><strong><sub>d</sub></strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>High V</strong><strong><sub>d</sub></strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A larger portion of a drug is in the <span class=\"customMeta\" data-dictid=\"837d6227d81692777190a063ea2cd4\">intravascular</span> compartment.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A larger portion of a drug is in the <span class=\"customMeta\" data-dictid=\"26e1dbfb921692777187208a4ff0e9\">extravascular</span> compartment.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is easily removed by haemodialysis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It can be difficult to remove by haemodialysis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Factors responsible:</p>\n<ul>\n<li>Extensive <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> protein binding</li>\n<li>Hydrophilic nature</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Factors responsible:</p>\n<ul>\n<li>Extensive body tissue binding</li>\n<li>Lipophilic nature</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Examples: warfarin, diclofenac</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Examples: Digoxin, propranolol, morphine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uxiOFUmVeXI4vqqYisVQ1727010838.mp3", "video": ""}, {"text": "Which of the following statements regarding elimination characteristics of \"hit and run\" drugs are incorrect? These drugs are eliminated quickly and have short half-lives. These drugs produce a prolonged effect even after they are eliminated from the body. These drugs require continuous administration to maintain their therapeutic effect. Omeprazole and reserpine are classified under these drugs. Regular blood samples are needed to monitor plasma concentration.", "options": [{"label": "A", "text": "1, 3 and 5", "correct": true}, {"label": "B", "text": "2, 3 and 5", "correct": false}, {"label": "C", "text": "3 and 4", "correct": false}, {"label": "D", "text": "1,2 and 3", "correct": false}], "correct_answer": "A. 1, 3 and 5", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6Xp9S8iOOcfP7nMiHU1v1727010689.mp3", "video": ""}, {"text": "A 32-year-old female on oral contraceptives containing estrogen is prescribed a course of ampicillin for a urinary tract infection. A few weeks later, she experiences an unexpected breakthrough bleeding and is concerned about the efficacy of her contraceptive. Which of the following describes the potential failure of her oral contraceptive?", "options": [{"label": "A", "text": "Antibiotics induce hepatic enzymes that increase estrogen metabolism", "correct": false}, {"label": "B", "text": "Antibiotics inhibit the absorption of estrogen in the stomach", "correct": false}, {"label": "C", "text": "Antibiotics destroy gut flora, reducing enterohepatic circulation of estrogen", "correct": true}, {"label": "D", "text": "Antibiotics increase renal excretion of estrogen", "correct": false}], "correct_answer": "C. Antibiotics destroy gut flora, reducing enterohepatic circulation of estrogen", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Xdx7EGbcYwqvLe4pLQZh1736535181.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0cVmilT44oieSVuiYRo51727010486.mp3", "video": ""}, {"text": "A 45-year-old male is undergoing treatment for latent tuberculosis with a standard regimen. After a few weeks of therapy, he develops peripheral neuropathy. His doctor explains that this side effect is related to the metabolism of isoniazid. Which type of phase II metabolism is responsible for this patient’s symptoms?", "options": [{"label": "A", "text": "Slow glucuronidation", "correct": false}, {"label": "B", "text": "Fast glucuronidation", "correct": false}, {"label": "C", "text": "Fast acetylation", "correct": false}, {"label": "D", "text": "Slow acetylation", "correct": true}], "correct_answer": "D. Slow acetylation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:591px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fast Acetylators</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Slow Acetylators</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NAT2 <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> activity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drug concentrations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased risk for</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"04f4b6dbf71692777192ca0c4f70fa\">microbial</span> cure.</li>\n<li>Increased relapse.</li>\n<li>Acquired drug resistance.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hepatotoxicity.</li>\n<li>Peripheral neuropathy/neuritis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2Lj1VJpSxckv9NFbRoLo1727010351.mp3", "video": ""}, {"text": "Match the following CYP450 enzymes with the drugs they primarily metabolise: CYP450 Enzyme Drug 1. CYP1A2 A. Phenytoin 2. CYP2C9 B. Midazolam 3. CYP2C19 C. Clopazine 4. CYP2D6 D. Pantoprazole 5. CYP3A4 E. Codeine", "options": [{"label": "A", "text": "1:D, 2:C, 3:A, 4:E, 5:B", "correct": false}, {"label": "B", "text": "1:C, 2:A, 3:D, 4:E, 5:B", "correct": true}, {"label": "C", "text": "1:C, 2:A, 3:E, 4:B, 5:D", "correct": false}, {"label": "D", "text": "1:A, 2:C, 3:B, 4:E, 5:D", "correct": false}], "correct_answer": "B. 1:C, 2:A, 3:D, 4:E, 5:B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:516px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CYP Enzymes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Substrates/Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP1A2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Theophylline</li>\n<li>Clozapine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2C9 (earlier CYP2C8)</p>\n<p>(Saturation <span class=\"customMeta\" data-dictid=\"2686f2899616927771900b3f9aee6b\">kinetics</span> is seen)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Phenytoin</li>\n<li>Warfarin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2C19</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Clopidogrel (see note below)</li>\n<li>Azoles: Voriconazole, Ketoconazole</li>\n<li>PPI: Omeprazole, Pantoprazole</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2D6</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Propranolol</li>\n<li>Quinidine</li>\n<li>Tamoxifen</li>\n<li>TCA</li>\n<li>SSRIs</li>\n<li>Opioids (Codeine)</li>\n<li>Antipsychotics (all except clozapine)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP2E1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Paracetamol</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CYP3A4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Astemizole</li>\n<li>Midazolam</li>\n<li>Cyclosporine/Tacrolimus</li>\n<li>Diltiazem/ verapamil</li>\n<li>Oral <span class=\"customMeta\" data-dictid=\"a13cdc2a8a1692777185da87f2ff85\">contraceptive</span> pills</li>\n<li>Fexofenadine/Terfenadine</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gO9ukYL0BcPa4nDFiZdG1727010198.mp3", "video": ""}, {"text": "In drug mechanisms observed in cancer cells, which of the following accurately describes the role of the P-glycoprotein pump (Pgp)?", "options": [{"label": "A", "text": "Pgp facilitates drug uptake into tumour cells", "correct": false}, {"label": "B", "text": "Pgp reduces drug elimination from tumour cells", "correct": false}, {"label": "C", "text": "Pgp is involved in drug efflux from tumour cells", "correct": true}, {"label": "D", "text": "Pgp has no significant impact on drug transport within tumour cells", "correct": false}], "correct_answer": "C. Pgp is involved in drug efflux from tumour cells", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:598px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P-glycoprotein Inducer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P-glycoprotein Inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Activity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases the activity of Pgp</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases the activity of Pgp</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rifampicin.</li>\n<li>Phenobarbitone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mnemonic: QVACKER</p>\n<ul>\n<li>Quinidine</li>\n<li><strong>Verapamil</strong></li>\n<li>Amiodarone</li>\n<li>Clarithromycin</li>\n<li>Ketoconazole</li>\n<li>Erythromycin</li>\n<li>Ritonavir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Combined with Substrate</p>\n<p>of p-glycoprotein</p>\n<p>(Digoxin)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases the activity of P-gp.</p>\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Digoxin is excreted.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces the activity of P-gp.</p>\n<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration of the drug.</li>\n<li>Toxicity of digoxin: Arrhythmias.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PrCzmbcodVqEErAf4NTR1727006443.mp3", "video": ""}, {"text": "Diazepam undergoes which of the following metabolic reactions?", "options": [{"label": "A", "text": "Glycination", "correct": false}, {"label": "B", "text": "Glucuronide conjugation", "correct": true}, {"label": "C", "text": "Sulfation", "correct": false}, {"label": "D", "text": "Methylation", "correct": false}], "correct_answer": "B. Glucuronide conjugation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Endogenous substances</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chloramphenicol.</li>\n<li>Paracetamol.</li>\n<li>Aspirin.</li>\n<li>Benzodiazepines: Diazepam, lorazepam.</li>\n<li>Morphine.</li>\n<li>Metronidazole.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bilirubin.</li>\n<li>Thyroxine.</li>\n<li>Steroidal hormones.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:647px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glycination (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glycination: The drugs are conjugated with glycine.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Salicylates.</li>\n<li>Nicotinic acid.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sulfation (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sulfation: The <span class=\"customMeta\" data-dictid=\"8cfbaec254169277719502145be7ce\">phenolic</span> compounds and steroids are sulfated by sulfotransferases.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chloramphenicol.</li>\n<li>Methyldopa.</li>\n<li>Adrenal &amp; sex steroids.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Methylation(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Methylation: The amines and phenols are <span class=\"customMeta\" data-dictid=\"4caa8e8b451692777192f014bc8995\">methylated</span> by <span class=\"customMeta\" data-dictid=\"bc09155adc169277719248f9543785\">methyl</span> transferases.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chloramphenicol.</li>\n<li>Methyldopa.</li>\n<li>Captopril.</li>\n<li>Mercaptopurine.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qL0PoSCZw1TfWnIgoGo21747034006.mp3", "video": ""}, {"text": "All of the following are phase 1 reactions except?", "options": [{"label": "A", "text": "Oxidation", "correct": false}, {"label": "B", "text": "Reduction", "correct": false}, {"label": "C", "text": "Methylation", "correct": true}, {"label": "D", "text": "Hydrolysis", "correct": false}], "correct_answer": "C. Methylation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:685px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Phase 1</strong></p>\n<p style=\"text-align: center;\">(Exposes <span class=\"customMeta\" data-dictid=\"be6b21068016927772030ce72d1e7c\">Functional group</span> on Drug)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Phase 2</strong></p>\n<p style=\"text-align: center;\">(Makes drug Water Soluble)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The activity of the drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drugs convert into active &amp; inactive forms.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The drug converts into active <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> only, except <span class=\"customMeta\" data-dictid=\"27d6d97dc51692777192f1043b6a79\">morphine</span> &amp; minoxidil.</li>\n<li>Enzymes transfer <span class=\"customMeta\" data-dictid=\"a274393046169277719601ea5a6864\">polar</span> groups.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Types of reaction and their site</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microsomal reactions:</p>\n<ul>\n<li><strong>Oxidation (Most Common)</strong> &amp; <strong>Reduction</strong> (mediated by CYP450 enzymes).</li>\n<li><strong>Hydrolysis.</strong></li>\n<li>Deamination.</li>\n<li>Dehydrogenation.</li>\n<li>Cyclisation.</li>\n<li>Decyclisation <strong>(Options A, B and D ruled out).</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Microsomal reaction:\n\t\t\t\t<ul>\n<li>Glucuronide conjugation.</li>\n</ul>\n</li>\n<li>Non-microsomal reactions:\n\t\t\t\t<ul>\n<li><strong>Acetylation.</strong></li>\n<li><strong>Methylation.</strong></li>\n<li>Sulfation.</li>\n<li>Glycination.</li>\n<li>Glutathionation.</li>\n<li>Ribonucleoside/nucleotide synthesis.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>M/C reaction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxidation &amp; reduction.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glucuronide conjugation.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/449F3OEkGMWJwRz75OuE1727008541.mp3", "video": ""}, {"text": "Match the following: Route Percentage Bioavailability 1) a) 100 2) b) 30-90 3) c) 75-100 4) d) 5-100", "options": [{"label": "A", "text": "1-d, 2-b, 3-c, 4-a", "correct": true}, {"label": "B", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}, {"label": "C", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-c, 4-d", "correct": false}], "correct_answer": "A. 1-d, 2-b, 3-c, 4-a", "question_images": ["https://image.prepladder.com/content/nAguk4EVQtSWV9UuOTBj1736534358.png", "https://image.prepladder.com/content/lQVHxwJjuWIIQMuTWDia1736534545.png", "https://image.prepladder.com/content/js4zOXiCA5v2iOexWEO11736534428.png", "https://image.prepladder.com/content/X05R5VmOCh6XNgjJ1xuY1736534518.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:338px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bioavailability in %</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1) Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2) Sublingual</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30-90</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3) Intramuscular</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4) Intravenous</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:450px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bioavailability Percentage</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sublingual</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30-90</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rectal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30-60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intramuscular (IM)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous (IV)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subcutaneous (SC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75 - 100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intranasal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20-50</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Transdermal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>80-100</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6VY3QKzaRQNQZIxqlHoJ1727008346.mp3", "video": ""}, {"text": "What is the effect of hypoalbuminemia on drugs with high plasma protein binding?", "options": [{"label": "A", "text": "Decreased drug efficacy", "correct": false}, {"label": "B", "text": "Increased drug efficacy", "correct": false}, {"label": "C", "text": "Increased risk of drug toxicity", "correct": true}, {"label": "D", "text": "Decreased risk of drug toxicity", "correct": false}], "correct_answer": "C. Increased risk of drug toxicity", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wbZBmMwZKNBLvRV4VyUI1727008043.mp3", "video": ""}, {"text": "Which statement regarding pharmacokinetics is incorrect?", "options": [{"label": "A", "text": "The volume of distribution (Vd) is a measure of drug distribution in the body", "correct": false}, {"label": "B", "text": "Clearance (Cl) represents the rate at which a drug is eliminated from the body", "correct": false}, {"label": "C", "text": "Bioavailability (F) is the fraction of an administered dose that reaches systemic circulation unchanged", "correct": false}, {"label": "D", "text": "The half-life (T1/2) is unaffected by liver metabolism", "correct": true}], "correct_answer": "D. The half-life (T1/2) is unaffected by liver metabolism", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qC8BERNPsxt88ZQ1fx7e1727007859.mp3", "video": ""}, {"text": "A 25-year-old patient presents with agitation, confusion, hyperthermia, and mydriasis. Urine toxicology confirms amphetamine use. What is the most appropriate management strategy for this patient?", "options": [{"label": "A", "text": "Benzodiazepines", "correct": false}, {"label": "B", "text": "Beta-blockers", "correct": false}, {"label": "C", "text": "Ammonium chloride", "correct": true}, {"label": "D", "text": "Sodium bicarbonate", "correct": false}], "correct_answer": "C. Ammonium chloride", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CNS Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Restlessness, dizziness, tremor, <span class=\"customMeta\" data-dictid=\"0d089d53fe16927771897887675ddc\">hyperactive</span> reflexes</li>\n<li>Talkativeness, tenseness, irritability, insomnia</li>\n<li>Euphoria, confusion, aggressiveness</li>\n<li>Anxiety, changes in libido, delirium, hallucinations (paranoid), panic states</li>\n<li>Suicidal or homicidal tendencies (especially in mentally ill)</li>\n<li>Fatigue and depression follow stimulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cardiovascular Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Headache, chilliness, pallor/flushing</li>\n<li>Palpitations, arrhythmias, <span class=\"customMeta\" data-dictid=\"e9fd0df8d31692777181d17788d36d\">anginal</span> pain</li>\n<li>Hypertension or hypotension</li>\n<li>Circulatory collapse</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gastrointestinal Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dry mouth, <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> taste, anorexia</li>\n<li>Nausea, vomiting, diarrhea, <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> cramps</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fever, excessive sweating</li>\n<li><strong>Fatal cases:</strong> convulsions, coma, cerebral hemorrhages</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dose-related Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Idiosyncratic reaction can occur with as little as 2 mg</li>\n<li>Severe reactions reported at 30 mg</li>\n<li>400–500 mg not uniformly fatal; chronic users tolerate higher doses</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Urinary acidification with <strong>ammonium chloride</strong> to enhance excretion</li>\n<li>Sedatives for CNS symptoms</li>\n<li>Sodium <span class=\"customMeta\" data-dictid=\"4e995cdee9169277719375efd43d38\">nitroprusside</span> or alpha-adrenergic <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> for severe hypertension</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nyqAykUcIgTFqaGGjtla1727007261.mp3", "video": ""}, {"text": "Which of the following statements is correct regarding drug absorption and excretion?", "options": [{"label": "A", "text": "Highly polar drugs are readily absorbed through the lipid membranes", "correct": false}, {"label": "B", "text": "Non-polar drugs are readily absorbed", "correct": true}, {"label": "C", "text": "Maximum unionisation of an acidic drug occurs in the small intestine", "correct": false}, {"label": "D", "text": "Non-ionized forms of drugs are less likely to be absorbed than ionised forms.", "correct": false}], "correct_answer": "B. Non-polar drugs are readily absorbed", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/aNZbEL54myBeQlqDb5tV1727007078.mp3", "video": ""}, {"text": "A 55-year-old male with chronic obstructive pulmonary disease (COPD) is being treated with theophylline. He is prescribed erythromycin for a respiratory tract infection. Which of the following outcomes is most likely due to the interaction between these two drugs?", "options": [{"label": "A", "text": "Decreased plasma concentration of theophylline", "correct": false}, {"label": "B", "text": "Increased risk of theophylline toxicity", "correct": true}, {"label": "C", "text": "No significant interaction", "correct": false}, {"label": "D", "text": "Decreased efficacy of erythromycin", "correct": false}], "correct_answer": "B. Increased risk of theophylline toxicity", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Zkwpq9MmNG2SXbyxUcj41736532994.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>imetidine.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G</strong>rapefruit juice (Furano coumarins).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>O</strong>meprazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>larithromycin &amp; <strong>C</strong>iprofloxacin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>K</strong>etoconazole.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong>cute alcoholism.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>E</strong>rythromycin.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>P</strong>rotease <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Ritonavir).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong>soniazid (inhibits all CYP enzymes except CYP2E1).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong>alproate.</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\">\n<tbody>\n<tr>\n<td>\n<p><strong>Enzyme inducers</strong></p>\n<p>(Mnemonic- GRAASS)</p>\n</td>\n<td>\n<p><strong>Enzyme inhibitors</strong></p>\n<p>(Mnemonic- <strong>COKE</strong> <strong>i</strong>n <strong>G</strong>allon <strong>C</strong>ontain <strong>A</strong>rtificial <strong>P</strong>reser<strong>v</strong>atives)</p>\n</td>\n</tr>\n<tr>\n<td>\n<ul>\n<li><strong>G</strong>riseofulvin</li>\n<li><strong>R</strong>ifampicin</li>\n<li><strong>A</strong>ntiepileptics\n\t\t\t\t<ul>\n<li>Phenytoin</li>\n<li>Carbamazepine</li>\n<li>Phenobarbital</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>A</strong>lcoholism (Chronic)</li>\n<li><strong>S</strong>moking</li>\n<li><strong>S</strong>t. John’s wart</li>\n</ul>\n</td>\n<td>\n<ul>\n<li><strong>C</strong>imetidine</li>\n<li><strong>O</strong>meprazole</li>\n<li><strong>K</strong>etoconazole</li>\n<li><strong>E</strong>rythromycin</li>\n<li><strong>I</strong>soniazid (inhibits all CYP enzymes except CYP2E1)</li>\n<li><strong>G</strong>rapefruit juice (Furano coumarins)</li>\n<li><strong>C</strong>larithromycin &amp; <strong>C</strong>iprofloxacin</li>\n<li><strong>A</strong>cute alcoholism</li>\n<li><strong>P</strong>rotease <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Ritonavir)</li>\n<li><strong>V</strong>alproate</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Wwb8VeHAksytjoGjANH21727006794.mp3", "video": ""}, {"text": "A patient with epilepsy is prescribed both Phenytoin and lamotrigine for seizure control. The patient reports worsening seizures despite adhering to the prescribed regimen. Which of the following best explains the potential reason for the failure of the regimen?", "options": [{"label": "A", "text": "Increased absorption of lamotrigine", "correct": false}, {"label": "B", "text": "Toxicity of lamotrigine", "correct": false}, {"label": "C", "text": "Increased metabolism of lamotrigine", "correct": true}, {"label": "D", "text": "Inhibition of transport of lamotrigine", "correct": false}], "correct_answer": "C. Increased metabolism of lamotrigine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:580px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Inducer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Griseofulvin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antifungal – induces CYP enzymes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rifampicin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Strong CYP3A4 inducer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antiepileptics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phenytoin, Carbamazepine, Phenobarbital – all induce metabolism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcohol (Chronic)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Induces CYP2E1</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Smoking</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Induces CYP1A2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>St. John’s Wort</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Induces CYP3A4 and P-gp</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:430px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Inhibitor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grapefruit juice</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits intestinal CYP3A4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Protease inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>e.g., <span class=\"customMeta\" data-dictid=\"dea585d18816927771975072308534\">ritonavir</span> – inhibits CYP3A4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Azoles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>e.g., <span class=\"customMeta\" data-dictid=\"03e69ce4341692777190edbcfbb900\">ketoconazole</span> – potent CYP inhibitors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cimetidine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H2 <span class=\"customMeta\" data-dictid=\"adecdf9cb2169277718363b8a0e491\">blocker</span> – inhibits multiple CYPs</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macrolides</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>e.g., <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> – inhibits CYP3A4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amiodarone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits CYP2C9, CYP3A4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-DHP CCBs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Verapamil, Diltiazem – <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> CYP3A4</p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Enzyme inducers</strong></p>\n<p style=\"text-align: center;\">(Mnemonic- GRAASS)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Enzyme inhibitors</strong></p>\n<p style=\"text-align: center;\">(Mnemonic- <strong>COKE</strong> <strong>i</strong>n <strong>G</strong>allon <strong>C</strong>ontain <strong>A</strong>rtificial <strong>P</strong>reser<strong>v</strong>atives)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>G</strong>riseofulvin</li>\n<li><strong>R</strong>ifampicin</li>\n<li><strong>A</strong>ntiepileptics\n\t\t\t\t<ul>\n<li>Phenytoin</li>\n<li>Carbamazepine</li>\n<li>Phenobarbital</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>A</strong>lcoholism (Chronic)</li>\n<li><strong>S</strong>moking</li>\n<li><strong>S</strong>t. John’s wart</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>C</strong>imetidine</li>\n<li><strong>O</strong>meprazole</li>\n<li><strong>K</strong>etoconazole</li>\n<li><strong>E</strong>rythromycin</li>\n<li><strong>I</strong>soniazid (inhibits all CYP enzymes except CYP2E1)</li>\n<li><strong>G</strong>rapefruit juice (Furano coumarins)</li>\n<li><strong>C</strong>larithromycin &amp; <strong>C</strong>iprofloxacin</li>\n<li><strong>A</strong>cute alcoholism</li>\n<li><strong>P</strong>rotease <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> (Ritonavir)</li>\n<li><strong>V</strong>alproate</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bkhLHygTFohbWr0VHjRU1727006663.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Adrenaline acting via beta 2 receptors causes bronchodilation, whereas histamine acts through H1 receptors to cause bronchoconstriction. Which type of antagonism is it?", "options": [{"label": "A", "text": "Physiological antagonism", "correct": true}, {"label": "B", "text": "Chemical antagonism", "correct": false}, {"label": "C", "text": "Non-Competitive Antagonist", "correct": false}, {"label": "D", "text": "Competitive antagonism", "correct": false}], "correct_answer": "A. Physiological antagonism", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\"&gt;Physiological&lt;/span&gt; antagonism&lt;br/&gt;\n&lt;br/&gt;\nExplanation: </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type of Antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Physiological Antagonist </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Involves two agents that produce opposite effects on the same <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> function without interacting directly with each other or the same receptor.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Histamine causes bronchoconstriction, while <span class=\"customMeta\" data-dictid=\"35b6a8aeb416927771805fcc2e7dfb\">adrenaline</span> causes bronchodilatation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Chemical Antagonist</strong></p>\n<p style=\"text-align: center;\"><strong>(Option B) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Direct interaction between two drugs to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> an inactive product.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Heparin</strong> works by enhancing the activity of <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III, which inhibits blood clotting.</li>\n<li><strong>Protamine sulfate</strong> binds to the negatively charged heparin, neutralizing its <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> effect.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Non-Competitive Antagonist </strong></p>\n<p style=\"text-align: center;\"><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prevents the action of an <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> without competing with it for the binding site.</li>\n<li><strong>Irreversible</strong> binding to the <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> reduces the maximum effect of the agonist.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Phenoxybenzamine binds to α-adrenergic receptors, reducing the effect of adrenaline.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Competitive Antagonist</strong></p>\n<p style=\"text-align: center;\"><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Competes with agonists for the same binding site, reducing the <span class=\"customMeta\" data-dictid=\"2a93f2d9a11692777196928bd78855\">potency</span> of the agonist.</li>\n<li><strong>Reversible </strong>binding to the same <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> site as the agonist.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Propranolol (β-blocker) binds to β-adrenergic receptors, reducing the effect of adrenaline.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the half-life of a drug with an elimination rate constant of 0.05 per hour?", "options": [{"label": "A", "text": "20.8 hours", "correct": false}, {"label": "B", "text": "6.9 hours", "correct": false}, {"label": "C", "text": "13.8 hours", "correct": true}, {"label": "D", "text": "9.8 hours", "correct": false}], "correct_answer": "C. 13.8 hours", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - 13.8 hou\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female patient recently diagnosed with tuberculosis was started on antitubercular therapy. Since she is using oral contraceptive pills, she was advised also to use a barrier method of contraception. Why was she given this advice?", "options": [{"label": "A", "text": "Teratogenicity of Antitubercular drugs", "correct": false}, {"label": "B", "text": "Failure of Antitubercular drugs", "correct": false}, {"label": "C", "text": "Rifampicin induces OCP metabolism and causes contraception failure", "correct": true}, {"label": "D", "text": "Rifampicin decreases OCP metabolism", "correct": false}], "correct_answer": "C. Rifampicin induces OCP metabolism and causes contraception failure", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Enzyme inducing drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Enzyme inhibiting drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Barbiturates</li>\n<li>Phenytoin</li>\n<li>Carbamazepine</li>\n<li>Rifampicin</li>\n<li>Cigarette smoking</li>\n<li>Chronic alcoholism</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Macrolides</li>\n<li>Azoles</li>\n<li>Chloramphenicol</li>\n<li>Omeprazole</li>\n<li>SSRI’s</li>\n<li>HIV <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors</li>\n<li>Cimetidine</li>\n<li>Metronidazole</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>P450 enzyme-inducing drugs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>P450 <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">Enzyme</span> inhibiting drugs </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Barbiturates</li>\n<li>Phenytoin</li>\n<li>Carbamazepine</li>\n<li>Rifampicin</li>\n<li>Cigarette smoking</li>\n<li>Chronic alcoholism</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Macrolides</li>\n<li>Azoles</li>\n<li>Chloramphenicol</li>\n<li>Omeprazole</li>\n<li>SSRI’s</li>\n<li>HIV <span class=\"customMeta\" data-dictid=\"fe13bbded1169277719694883c6ba4\">protease</span> inhibitors</li>\n<li>Cimetidine</li>\n<li>Metronidazole</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on Digoxin, Potassium chloride, Clarithromycin, Atenolol and Triamterene developed atrial fibrillation with controlled ventricular rate. Investigations showed elevated Digoxin levels. Which of the following drugs is responsible for the rise in serum Digoxin?", "options": [{"label": "A", "text": "Potassium Chloride", "correct": false}, {"label": "B", "text": "Clarithromycin", "correct": true}, {"label": "C", "text": "Atenolol", "correct": false}, {"label": "D", "text": "Rifampicin", "correct": false}], "correct_answer": "B. Clarithromycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>P-glycoprotein Inducer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>P-glycoprotein Inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Activity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of Pgp</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decreases the activity of Pgp</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rifampicin</li>\n<li>Phenobarbitone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mnemonic: QVACKER</p>\n<ul>\n<li>Quinidine</li>\n<li><strong>Verapamil</strong></li>\n<li>Amiodarone</li>\n<li>Clarithromycin</li>\n<li>Ketoconazole</li>\n<li>Erythromycin</li>\n<li>Ritonavir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Combined with Substrate</strong></p>\n<p><strong>of p-glycoprotein</strong></p>\n<p><strong>(Digoxin)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of P-gp.</p>\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Digoxin is excreted.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces the activity of P-gp.</p>\n<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration of the drug.</li>\n<li>Toxicity of digoxin: Arrhythmias.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "As a medical practitioner in India, how will you prescribe Alprazolam to a patient?", "options": [{"label": "A", "text": "1mg OD HS for 7 days", "correct": false}, {"label": "B", "text": "0.5 mg OD HS for 7 days", "correct": false}, {"label": "C", "text": "0.5 mg BD for 7 days", "correct": false}, {"label": "D", "text": "0.5 mg once daily before bedtime for 7 days", "correct": true}], "correct_answer": "D. 0.5 mg once daily before bedtime for 7 days", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the dosing rate of a drug based on?", "options": [{"label": "A", "text": "Clearance / desired peak plasma concentration", "correct": false}, {"label": "B", "text": "Clearance of drug X desired peak plasma concentration", "correct": true}, {"label": "C", "text": "Clearance X loading dose", "correct": false}, {"label": "D", "text": "Clearance/loading dose", "correct": false}], "correct_answer": "B. Clearance of drug X desired peak plasma concentration", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\">Steady-state concentration = dosing rate/clearance</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Loading dose = <span class=\"customMeta\" data-dictid=\"ee6800538c169277720292cf2d4f1c\">Volume of distribution</span> X Desired steady-state <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Maintenance dose = Target <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration X <span class=\"customMeta\" data-dictid=\"3a3fb1b8a816927771840e6a344cc0\">Clearance</span> X Dosing interval</p>\n<p style=\"text-align: center;\">Bioavailability (F)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Dosing rate = <span class=\"customMeta\" data-dictid=\"3a3fb1b8a816927771840e6a344cc0\">Clearance</span> of drug X desired peak <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a prodrug?", "options": [{"label": "A", "text": "Proguanil", "correct": false}, {"label": "B", "text": "Sulindac", "correct": false}, {"label": "C", "text": "Primidone", "correct": true}, {"label": "D", "text": "Flurouracil", "correct": false}], "correct_answer": "C. Primidone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Primidone</p>\n<table cellspacing=\"0\">\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Prodrug</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Active Form</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Levodopa</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Dopamine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Enalapril</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Enalaprilat</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>α-Methyldopa</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">α-Methyl norepinephrine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Dipivefrine</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Epinephrine</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Proguanil</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Cycloguanil</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Prednisone</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Prednisolone</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Clopidogrel</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Thiol metabolite</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Bacampicillin</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Ampicillin</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Sulfasalazine</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">5-Aminosalicylic acid</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Cyclophosphamide</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Aldophosphamide, phosphoramide mustard, acrolein</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Fluorouracil</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Fluorouridine monophosphate</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Mercaptopurine</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Methylmercaptopurine ribonucleotide</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Acyclovir</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\">Acyclovir triphosphate</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "a. 1:1000 1. Cardiac arrest b. 1:10000 2. Anaphylaxis c. 1:100000 3. Local anesthesia", "options": [{"label": "A", "text": "a-1, b-2, c-3", "correct": false}, {"label": "B", "text": "a-2, b-1, c-3", "correct": true}, {"label": "C", "text": "a-3, b-2, c-1", "correct": false}, {"label": "D", "text": "a-1, b-3, c-2", "correct": false}], "correct_answer": "B. a-2, b-1, c-3", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - a-2, b-1, c-3</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Use</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Dilution/Concentration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Route of Administration</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Anaphylaxis</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>First-line treatment for severe allergic reactions</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intramuscular (IM)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Cardiac arrest</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>To restore <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> rhythm and blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:10,000 (0.1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intravenous (IV)</li>\n<li>Intraosseous (IO)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Asthma</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> severe <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> attacks</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:1000 (1 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Inhalation via nebulizer</li>\n<li>Intramuscular (IM)</li>\n<li>subcutaneous (SC)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Hypotension</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>To increase blood pressure</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:100,000 (0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Intravenous (IV) infusion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Local anesthesia</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>Enhance duration and intensity of local <span class=\"customMeta\" data-dictid=\"4b83ec31581692777181547f1a89ef\">anesthetic</span> effect</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:none; border-top:none\">\n<p>1:200,000 to 1:100,000 (0.005 to 0.01 mg/mL)</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:none\">\n<ul>\n<li>Local injection</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a use of enteric-coated drugs? a) Protect the acid-labile drug from gastric acidity b) Protect the gastric mucosa from the irritant effects of certain drugs c) Prolongs the half-life of the drug d) Deliver drugs distal to the stomach", "options": [{"label": "A", "text": "a, b &amp;amp; c", "correct": false}, {"label": "B", "text": "b, c &amp;amp; d", "correct": false}, {"label": "C", "text": "a, c &amp;amp; d", "correct": false}, {"label": "D", "text": "c", "correct": true}], "correct_answer": "D. c", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs should not be combined with rosuvastatin?", "options": [{"label": "A", "text": "Oxycodone", "correct": false}, {"label": "B", "text": "Clarithromycin", "correct": true}, {"label": "C", "text": "Adalimumab", "correct": false}, {"label": "D", "text": "Rivaroxaban", "correct": false}], "correct_answer": "B. Clarithromycin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Clarith\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The normality of 2M HCl when compared to 1M H₂SO₄ is:", "options": [{"label": "A", "text": "Half", "correct": false}, {"label": "B", "text": "Twice", "correct": false}, {"label": "C", "text": "Same", "correct": true}, {"label": "D", "text": "4 times", "correct": false}], "correct_answer": "C. Same", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which statement is accurate regarding a patient receiving a high dosage of both penicillin and gentamicin?", "options": [{"label": "A", "text": "TDM is done for penicillin because of the narrow therapeutic index", "correct": false}, {"label": "B", "text": "TDM is done for gentamicin", "correct": true}, {"label": "C", "text": "TDM is done with both because of dangerous side effects", "correct": false}, {"label": "D", "text": "Both drugs do not need monitoring", "correct": false}], "correct_answer": "B. TDM is done for gentamicin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - TDM is done for g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following should not be prescribed with theophylline?", "options": [{"label": "A", "text": "Erythromycin", "correct": true}, {"label": "B", "text": "Cefotaxime", "correct": false}, {"label": "C", "text": "Cotrimoxazole", "correct": false}, {"label": "D", "text": "Amoxicillin", "correct": false}], "correct_answer": "A. Erythromycin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Based on the graph given below shows the relationship between the log dose and the response of Drugs A, B and C. Which of the following has the highest potency?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "Both A and B", "correct": false}, {"label": "D", "text": "C", "correct": false}], "correct_answer": "A. A", "question_images": ["https://image.prepladder.com/content/Kk4XfNLqeYmtXI457YZZ1746518904.png"], "explanation_images": [], "explanation": "<p>Correct Answer A - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a clinical trial evaluating the efficacy of a new drug, a normal efficacy potecy graph is used. Which of the following statements regarding the graph is true?", "options": [{"label": "A", "text": "The graph shows the relationship between drug potency and its efficacy", "correct": false}, {"label": "B", "text": "The graph demonstrates that higher potency always leads to higher efficacy", "correct": false}, {"label": "C", "text": "The graph represents the dose-response curve for the drug", "correct": true}, {"label": "D", "text": "The graph indicates that drugs with low potency can never be effective", "correct": false}], "correct_answer": "C. The graph represents the dose-response curve for the drug", "question_images": ["https://image.prepladder.com/content/qXmtoOLuvLUmKKvX1KOK1746698324.png"], "explanation_images": [], "explanation": "<p>Correct Answer C - The &lt;span class=\"customMeta\" data-dictid=\"90b63cdcfe16927771885e9612aecb\"&gt;graph&lt;/span&gt; represents the &lt;span class=\"customMeta\" data-dictid=\"24e5d1dd8e1692777186ce70f3f91b\"&gt;dose-response curve&lt;/span&gt; for the drug\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is absolutely contraindicated in pregnancy?", "options": [{"label": "A", "text": "Captopril", "correct": true}, {"label": "B", "text": "Paracetamol", "correct": false}, {"label": "C", "text": "Ranitidine", "correct": false}, {"label": "D", "text": "Cefixime", "correct": false}], "correct_answer": "A. Captopril", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Teratogenic drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Teratogenic Disorder</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Acitretin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Craniofacial anomalies, heart defects, CNS malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Alcohol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Fetal Alcohol Syndrome</strong> (growth retardation, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> anomalies, CNS dysfunction, ASD, VSD).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>ACE inhibitors &amp; Angiotensin-receptor blockers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Renal dysgenesis, oligohydramnios, lung hypoplasia, skull hypoplasia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Carbamazepine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Neural tube defects (spina bifida), <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Isotretinoin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Craniofacial anomalies, heart defects, CNS malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Lithium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Ebstein's <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> (tricuspid <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> malformation)</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Thalidomide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Severe limb defects (phocomelia), ear, cardiac, and <span class=\"customMeta\" data-dictid=\"2fd33fb2ac16927771889901daadeb\">genitourinary</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Carbimazole &amp; methimazole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Choanal atresia, <span class=\"customMeta\" data-dictid=\"5dff4943631692777181b8974b302b\">aplasia</span> cutis, and <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> goitre.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Penicillamine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Cutis laxa syndrome.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Statins</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Vertebral, anal, cardiac, tracheo-oesophageal fistula, renal, arterial, and limb defects (<strong>VACTERAL</strong> defects).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>SSRIs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Persistent <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> of the newborn.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Valproic acid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Neural tube defects (spina bifida), <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> malformations, and developmental delay.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Warfarin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Fetal <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> syndrome:</strong> Nasal hypoplasia, <span class=\"customMeta\" data-dictid=\"3d7836b47f1692777199a5bbfc749f\">stippled</span> epiphyses, limb hypoplasia, and central nervous system abnormalities.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The therapeutic index of a drug serves as a measure for?", "options": [{"label": "A", "text": "Potency", "correct": false}, {"label": "B", "text": "Safety", "correct": true}, {"label": "C", "text": "Efficacy", "correct": false}, {"label": "D", "text": "All of these", "correct": false}], "correct_answer": "B. Safety", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/soRsuuWyy06yqmHEMLDD1747028690.png", "https://image.prepladder.com/content/7djOgvboozBzgnTPAP4j1747028724.png", "https://image.prepladder.com/content/WIG9w26E50hpcpgqDlA21747028752.png"], "explanation": "<p>Correct Answer B - Safety&lt;br/&gt;\n&lt;br/&gt;\nExplanation: </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\">TI= <span class=\"customMeta\" data-dictid=\"979385c98a1692777192fb1721a16e\">median</span> <strong>toxic dose</strong>/median <strong>effective dose</strong> ; (TD50/ED50)</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs is not metabolized by acetylation?", "options": [{"label": "A", "text": "Isoniazid", "correct": false}, {"label": "B", "text": "Hydralazine", "correct": false}, {"label": "C", "text": "Phenytoin", "correct": true}, {"label": "D", "text": "Procainamide", "correct": false}], "correct_answer": "C. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Phenytoin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Reaction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Acetylation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acetylation: N-acetyltransferase (NAT), adds an <span class=\"customMeta\" data-dictid=\"6ade0969281692777180216b0c3d76\">acetyl</span> group to drugs and compounds</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Isoniazid <strong>(Option A)</strong></li>\n<li>Hydralazine <strong>(Option B)</strong></li>\n<li>Phenelzine</li>\n<li>Dapsone</li>\n<li>Procainamide<strong> (Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Glycination </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glycination: The drugs are conjugated with glycine.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Salicylates.</li>\n<li>Nicotinic acid.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sulfation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sulfation: The <span class=\"customMeta\" data-dictid=\"8cfbaec254169277719502145be7ce\">phenolic</span> compounds and steroids are sulfated by sulfotransferases.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chloramphenicol.</li>\n<li>Methyldopa.</li>\n<li>Adrenal &amp; sex steroids.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Methylation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Methylation: The amines and phenols are <span class=\"customMeta\" data-dictid=\"4caa8e8b451692777192f014bc8995\">methylated</span> by <span class=\"customMeta\" data-dictid=\"bc09155adc169277719248f9543785\">methyl</span> transferases.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chloramphenicol.</li>\n<li>Methyldopa.</li>\n<li>Captopril.</li>\n<li>Mercaptopurine.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Pharmacodynamics deals with?", "options": [{"label": "A", "text": "Mode of excretion of drug", "correct": false}, {"label": "B", "text": "Mechanism of action of a drug", "correct": true}, {"label": "C", "text": "Transport of drugs across the biological membrane", "correct": false}, {"label": "D", "text": "Latency of onset", "correct": false}], "correct_answer": "B. Mechanism of action of a drug", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Mechanism of action of a drug\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A new drug is introduced into the market after which phase of the clinical trials?", "options": [{"label": "A", "text": "Phase I", "correct": false}, {"label": "B", "text": "Phase II", "correct": false}, {"label": "C", "text": "Phase III", "correct": true}, {"label": "D", "text": "Phase IV", "correct": false}], "correct_answer": "C. Phase III", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical trials </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phases</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phase 0</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Design: An open-label trial</strong></li>\n<li><strong>Purpose:</strong>\n<ul>\n<li><strong>Check the target binding of a drug</strong></li>\n<li><strong>Check the <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> of the drug</strong></li>\n</ul>\n</li>\n<li><strong>Called a micro-dosing trial (100 micrograms dose)</strong></li>\n<li><strong>Non-mandatory clinical trial</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phase I</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Design: An open-label trial</strong></li>\n<li><strong>Purpose:</strong>\n<ul>\n<li><strong>Evaluate drug safety- the most important</strong></li>\n<li><strong>Evaluate MTD (maximum tolerable dose), <span class=\"customMeta\" data-dictid=\"00a5dcc74b16927771913b344e36a3\">loading</span> dose, and drug half-life.</strong></li>\n<li><strong>Evaluate drug <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> (absorption, distribution, <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and excretion)</strong></li>\n</ul>\n</li>\n<li><strong>Called the first human trial</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phase II</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Design: Randomized <span class=\"customMeta\" data-dictid=\"df216bc99216927771841f3321f8cb\">clinical trial</span> (RCT)</strong></li>\n<li><strong>Purpose:</strong>\n<ul>\n<li><strong>Explore drug efficacy</strong></li>\n</ul>\n</li>\n<li><strong>Called a <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> exploratory trial or proof of concept trial</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phase III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Design: Double-blinded RCT</strong></li>\n<li><strong>Purpose:</strong>\n<ul>\n<li><strong>Find the <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> drug dose</strong></li>\n<li><strong>Confirm efficacy</strong></li>\n<li><strong>Safety is priority</strong></li>\n</ul>\n</li>\n<li><strong>Called a <span class=\"customMeta\" data-dictid=\"8dfaeedbf91692777200561b2b1d2f\">therapeutic</span> confirmatory trial</strong></li>\n<li><strong>Called multi-site trial (done on a <span class=\"customMeta\" data-dictid=\"bbe1b94c491692777188fe4f85b1ce\">heterogeneous</span> population)</strong></li>\n<li><strong>Drugs get market approval</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phase IV</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Design: Open-label</li>\n<li>Purpose:\n\t\t\t\t<ul>\n<li>Find hidden/missed/rare adverse effects.</li>\n<li>Evaluate compliance: <strong>long-term side effects</strong></li>\n<li><strong>Drug interactions</strong></li>\n<li>Food interactions</li>\n</ul>\n</li>\n<li>Called post-marketing surveillance</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding the dose-response curve shown in the image below ?", "options": [{"label": "A", "text": "C is competitive antagonist", "correct": false}, {"label": "B", "text": "C is more potent than A", "correct": false}, {"label": "C", "text": "B is more potent than A", "correct": false}, {"label": "D", "text": "B is competitive antagonist", "correct": true}], "correct_answer": "D. B is competitive antagonist", "question_images": ["https://image.prepladder.com/content/ytghAipXzRjtPJTWaYpq1691506846.png"], "explanation_images": [], "explanation": "<p>Correct Option D - B is competitive antag\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug's action is prolonged by the administration of cilastatin?", "options": [{"label": "A", "text": "Meropenem", "correct": false}, {"label": "B", "text": "Imipenem", "correct": true}, {"label": "C", "text": "Cefazolin", "correct": false}, {"label": "D", "text": "Piperacillin", "correct": false}], "correct_answer": "B. Imipenem", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - I\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the drug categorized as schedule X from the options provided.", "options": [{"label": "A", "text": "Halothane", "correct": false}, {"label": "B", "text": "Thalidomide", "correct": false}, {"label": "C", "text": "Ketamine", "correct": true}, {"label": "D", "text": "Colistin", "correct": false}], "correct_answer": "C. Ketamine", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p>Drug Class</p>\n</td>\n<td>\n<p>Opioids, Benzodiazepines, Barbiturates</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Examples</p>\n</td>\n<td>\n<p>Morphine, Oxycodone, Diazepam, Alprazolam</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following causes an increase in ACh release from the presynaptic neuron ?", "options": [{"label": "A", "text": "Potassium channel blocker", "correct": true}, {"label": "B", "text": "Sodium channel blocker", "correct": false}, {"label": "C", "text": "Calcium channel blocker", "correct": false}, {"label": "D", "text": "Chlorine channel blocker", "correct": false}], "correct_answer": "A. Potassium channel blocker", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\"&gt;Potassium&lt;/span&gt; channel block\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the extent of drug absorption when it is given intravenously?", "options": [{"label": "A", "text": "10%", "correct": false}, {"label": "B", "text": "b. 100%", "correct": true}, {"label": "C", "text": "50%", "correct": false}, {"label": "D", "text": "Variable", "correct": false}], "correct_answer": "B. b. 100%", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - 100%\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old patient with a history of epilepsy is prescribed a combination of carbamazepine and valproate for seizure control. Several weeks into the treatment, the patient presents with abdominal pain, jaundice, and elevated liver enzymes. What is the most likely adverse effect associated with this medication combination?", "options": [{"label": "A", "text": "Pancreatitis", "correct": false}, {"label": "B", "text": "Thrombocytopenia", "correct": false}, {"label": "C", "text": "Hepatotoxicity", "correct": true}, {"label": "D", "text": "Hyperammonemia", "correct": false}], "correct_answer": "C. Hepatotoxicity", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - H\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of dapsone, considering that it is used in the treatment of leprosy, and fungal infections and, also for immunomodulatory actions?", "options": [{"label": "A", "text": "Cell wall synthesis inhibitor", "correct": false}, {"label": "B", "text": "Folic acid synthesis inhibitor", "correct": true}, {"label": "C", "text": "Protein synthesis inhibitor", "correct": false}, {"label": "D", "text": "Cell membrane inhibitor", "correct": false}], "correct_answer": "B. Folic acid synthesis inhibitor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"778971b8f5169277720391773cc8fa\"&gt;Folic acid&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\"&gt;synthesis&lt;/span&gt; inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A drug label suggests storage in a ‘cool’ place. What is the temperature at which this drug is to be stored?", "options": [{"label": "A", "text": "-2 degree Celsius", "correct": false}, {"label": "B", "text": "0 degree Celsius", "correct": false}, {"label": "C", "text": "2-8 degree Celsius", "correct": true}, {"label": "D", "text": "8-15 degrees Celsius", "correct": false}], "correct_answer": "C. 2-8 degree Celsius", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - 2-8 degrees Celsiu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is an example of a GPCR?", "options": [{"label": "A", "text": "Muscarinic", "correct": true}, {"label": "B", "text": "Nicotinic", "correct": false}, {"label": "C", "text": "GABA-A", "correct": false}, {"label": "D", "text": "Insulin", "correct": false}], "correct_answer": "A. Muscarinic", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\"&gt;Muscarinic&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which parameter is utilized to evaluate the level of drug absorption in a graph demonstrating plasma concentration versus time?", "options": [{"label": "A", "text": "Tmax", "correct": false}, {"label": "B", "text": "Cmax", "correct": false}, {"label": "C", "text": "T1/2", "correct": false}, {"label": "D", "text": "Area under the curve", "correct": true}], "correct_answer": "D. Area under the curve", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"c7f537f27d1692777182bba0a52177\"&gt;AUC&lt;/span&gt; (Area under the curve)\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following describes LD 50?", "options": [{"label": "A", "text": "50% animal mortality is an experiment after exposure to the drug", "correct": true}, {"label": "B", "text": "50% reduction of infection in the given population of experimental animals", "correct": false}, {"label": "C", "text": "Dose of the drug that causes adverse effects in 50% of the population", "correct": false}, {"label": "D", "text": "Range of concentration at which the likelihood of efficacy is high and the probability of adverse effects is low", "correct": false}], "correct_answer": "A. 50% animal mortality is an experiment after exposure to the drug", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/SaBBReXSGQn0fXgUFkoH1715143598.png"], "explanation": "<p>Correct Option A - 50% animal mortality is an experiment after exposure to the drug\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following acts via the JAK-STAT pathway?", "options": [{"label": "A", "text": "Calcitonin", "correct": false}, {"label": "B", "text": "Vasopressin", "correct": false}, {"label": "C", "text": "Aldosterone", "correct": false}, {"label": "D", "text": "Leptin", "correct": true}], "correct_answer": "D. Leptin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - L\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Cyclosporine-induced cholestasis is due to which receptor?", "options": [{"label": "A", "text": "BRCA", "correct": false}, {"label": "B", "text": "OATP1B1", "correct": false}, {"label": "C", "text": "MDR1", "correct": true}, {"label": "D", "text": "MRP1", "correct": false}], "correct_answer": "C. MDR1", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - MDR\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>P-glycoprotein Inducer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>P-glycoprotein Inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Activity</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of Pgp</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decreases the activity of Pgp</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rifampicin.</li>\n<li>Phenobarbitone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mnemonic: QVACKER</p>\n<ul>\n<li>Quinidine</li>\n<li><strong>Verapamil</strong></li>\n<li>Amiodarone</li>\n<li>Clarithromycin</li>\n<li>Ketoconazole</li>\n<li>Erythromycin</li>\n<li>Ritonavir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Combined with <span class=\"customMeta\" data-dictid=\"385d52533a169277719991c090c3d7\">Substrate</span> of <span class=\"customMeta\" data-dictid=\"24226779e7169277719450dba851bc\">p-glycoprotein</span> (Digoxin)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of P-gp.</p>\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Digoxin is excreted.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces the activity of P-gp.</p>\n<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration of the drug.</li>\n<li>Toxicity of digoxin: Arrhythmias.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true about therapeutic index of a drug?", "options": [{"label": "A", "text": "Denotes safety and efficacy in population", "correct": true}, {"label": "B", "text": "Denotes safety and efficacy in individual", "correct": false}, {"label": "C", "text": "Ratio of median lethal dose in 50% of population to median effective dose in 50% of population", "correct": false}, {"label": "D", "text": "Denotes safety and efficacy after experiments in humans", "correct": false}], "correct_answer": "A. Denotes safety and efficacy in population", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/GDLKkuzmGjsX7TTNMxcT1745931236.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>TI= <span class=\"customMeta\" data-dictid=\"979385c98a1692777192fb1721a16e\">median</span> <strong>toxic dose</strong>/median <strong>effective dose</strong> ; (TD50/ED50)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs acts by inhibiting ATP-binding cassette transporter?", "options": [{"label": "A", "text": "Tacrolimus", "correct": false}, {"label": "B", "text": "Nifedipine", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Verapamil", "correct": true}], "correct_answer": "D. Verapamil", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Verapamil</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>P-glycoprotein Inducer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>P-glycoprotein Inhibitor</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Activity</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of Pgp</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decreases the activity of Pgp</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drugs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rifampicin.</li>\n<li>Phenobarbitone.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mnemonic: QVACKER</p>\n<ul>\n<li>Quinidine</li>\n<li><strong>Verapamil</strong></li>\n<li>Amiodarone</li>\n<li>Clarithromycin</li>\n<li>Ketoconazole</li>\n<li>Erythromycin</li>\n<li>Ritonavir</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Combined with Substrate</p>\n<p>of p-glycoprotein</p>\n<p>(Digoxin)</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increases the activity of P-gp.</p>\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Digoxin is excreted.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces the activity of P-gp.</p>\n<ul>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> excretion.</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration of the drug.</li>\n<li>Toxicity of digoxin: Arrhythmias.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following acts by suicide inhibition? 1) Spironolactone 2) Ethinyl estradiol 3) Benzbromarone 4) Ritonavir", "options": [{"label": "A", "text": "1, 2, and 3", "correct": false}, {"label": "B", "text": "1 and 2", "correct": false}, {"label": "C", "text": "3 and 4", "correct": true}, {"label": "D", "text": "1, 3, and 4", "correct": false}], "correct_answer": "C. 3 and 4", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - 3 and 4\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was given digoxin and started having side effects like nausea and vomiting. The serum concentration of digoxin was 4 ng/ml, and the plasma therapeutic range was 1 ng/ml. If the half-life of digoxin is 40 hours, what time is required till you can safely start digoxin again?", "options": [{"label": "A", "text": "40 hours", "correct": false}, {"label": "B", "text": "80 hours", "correct": true}, {"label": "C", "text": "120 hours", "correct": false}, {"label": "D", "text": "140-180 hours", "correct": false}], "correct_answer": "B. 80 hours", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - 80 hou\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A log dose-response curve (DRC) was plotted with isoprenaline alone and with isoprenaline in the presence of propranolol, as shown below. The graph shows that propranolol is a:", "options": [{"label": "A", "text": "Partial agonist", "correct": false}, {"label": "B", "text": "Agonist", "correct": false}, {"label": "C", "text": "Competitive antagonist", "correct": true}, {"label": "D", "text": "Non-competitive antagonist", "correct": false}], "correct_answer": "C. Competitive antagonist", "question_images": ["https://image.prepladder.com/notes/sKzb6Ge6ot8LLou8kaM71747662221.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which vitamin deficiency is most likely responsible for the chronic alcoholic patient’s presentation with confusion, aphasia, unstable gait, and symptoms related to Wernicke’s encephalopathy?", "options": [{"label": "A", "text": "Vit B1", "correct": true}, {"label": "B", "text": "Vit C", "correct": false}, {"label": "C", "text": "Vit D", "correct": false}, {"label": "D", "text": "Vit B3", "correct": false}], "correct_answer": "A. Vit B1", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Vit B1</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Manifestations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wernicke Encephalopathy:</strong></p>\n<ul>\n<li>Symptoms: Ophthalmoplegia, nystagmus, cerebellar ataxia, global confusion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Korsakoff Psychosis:</strong></p>\n<ul>\n<li>Symptoms: <span class=\"customMeta\" data-dictid=\"6f04a43a8c16927771816dd61a4f17\">Anterograde</span> and <span class=\"customMeta\" data-dictid=\"e38ca8e6931692777197ee6a68ac56\">retrograde</span> amnesia, <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> agnosia, and confabulation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes of <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">Thiamine</span> <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">Deficiency</span> in Alcoholics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increased <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">thiamine</span> requirements due to alcohol consumption. Alcohol is a source of empty calories.</li>\n<li>Inhibition of intestinal <span class=\"customMeta\" data-dictid=\"b70d1dbde516927772000d7774d2a5\">thiamine</span> <span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\">absorption</span> by alcohol.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic Implications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Impaired conversion of <span class=\"customMeta\" data-dictid=\"f9129e152d16927771960c4ccc40bc\">pyruvate</span> to acetyl-CoA.</li>\n<li>Accumulation of <span class=\"customMeta\" data-dictid=\"f9129e152d16927771960c4ccc40bc\">pyruvate</span> and <span class=\"customMeta\" data-dictid=\"5a751dc161169277719123aae1b764\">lactate</span> in the blood.</li>\n<li>Potential for life-threatening <span class=\"customMeta\" data-dictid=\"b82539c9ae1692777191a3f7ddd7bb\">lactic</span> acidosis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old patient with hypertension has been prescribed Drug X, which has a bioavailability of 30%. Which of the following is the most appropriate statement for this patient's drug prescription?", "options": [{"label": "A", "text": "70% of drugs reach systemic circulation in unchanged form", "correct": false}, {"label": "B", "text": "30% of the drug is pure", "correct": false}, {"label": "C", "text": "70% of drugs is potent in giving therapeutic effect", "correct": false}, {"label": "D", "text": "70% of the drug undergoes 1 st pass metabolism in the liver", "correct": true}], "correct_answer": "D. 70% of the drug undergoes 1 st pass metabolism in the liver", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route of Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bioavailability Percentage</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sublingual</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30-90</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rectal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>30-60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intramuscular (IM)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75-100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous (IV)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subcutaneous (SC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75 - 100</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intranasal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20-50</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Transdermal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>80-100</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Loading dose of drug is dependent on:", "options": [{"label": "A", "text": "Clearance", "correct": false}, {"label": "B", "text": "Route of administration", "correct": false}, {"label": "C", "text": "Volume of distribution", "correct": true}, {"label": "D", "text": "Bioavailability", "correct": false}], "correct_answer": "C. Volume of distribution", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/1ggOwLxy81Tj2OAKBZCR1724824047.png"], "explanation": "<p>Correct Option C - Volume of distribu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Category A, B, C, D, and X in drug classification are indicative of which of the following?", "options": [{"label": "A", "text": "Safety in pregnancy", "correct": true}, {"label": "B", "text": "Dose adjustment in renal failure", "correct": false}, {"label": "C", "text": "Cost ratio from cheap to expensive", "correct": false}, {"label": "D", "text": "As per the safety or therapeutic index", "correct": false}], "correct_answer": "A. Safety in pregnancy", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Safety in pregnancy:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n<p><strong>Category A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Adequate and well-controlled studies have failed to demonstrate a risk to the <span class=\"customMeta\" data-dictid=\"421fecf0e21692777202704942ac48\">fetus</span> in the first <span class=\"customMeta\" data-dictid=\"2c20f0f1dd169277720029d29458d5\">trimester</span> of pregnancy, and there is no evidence of risk in later trimesters.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Examples - <strong>Doxylamine, <span class=\"customMeta\" data-dictid=\"c66705291e1692777203ed3498a606\">Folate</span> and Levothyroxine</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Category B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Animal <span class=\"customMeta\" data-dictid=\"7a47c14dc91692777197a27e7aa854\">reproduction</span> studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Animal <span class=\"customMeta\" data-dictid=\"7a47c14dc91692777197a27e7aa854\">reproduction</span> studies have shown an adverse effect on the fetus, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the <span class=\"customMeta\" data-dictid=\"421fecf0e21692777202704942ac48\">fetus</span> in any trimester.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Examples - <strong>Amoxicillin and <span class=\"customMeta\" data-dictid=\"9c2990aa601692777194f8ab17e3d5\">Ondansetron</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Category C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Animal <span class=\"customMeta\" data-dictid=\"7a47c14dc91692777197a27e7aa854\">reproduction</span> studies have shown an adverse effect on the fetus, and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Examples - <strong>Metoprolol and <span class=\"customMeta\" data-dictid=\"e3d616618b16927772022df400a411\">fluconazole</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Category D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>There is positive evidence of human <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant the use of the drug in pregnant women despite potential risks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Examples - <strong>ACE inhibitors, <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">Lithium</span> and Phenytoin</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Category X</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Studies in animals or humans have demonstrated <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> abnormalities, and there is positive evidence of human <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> risk based on adverse reaction data from investigational or marketing experience.</p>\n<p>Risks involved inthe use of the drug in pregnant women clearly outweigh the potential benefit.s</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Examples - <strong>Methotrexate, <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">Warfarin</span> and Statins</strong></p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Biological and Special Products: Includes sera, vaccines, toxins, antitoxins, insulin, etc.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drugs: Extends to <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> kits and reagents, including various biotechnological products.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Substances: These include toxic substances such as poisonous plants and their preparations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule F</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vaccines and Sera: Specifies standards for blood products and <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> antigens.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule G</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prescription Drugs: Drugs that should be taken under medical supervision only and must carry a warning.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule H</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prescription Only Drugs: Sale is restricted to prescriptions from a registered medical practitioner.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule J</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Diseases: List of diseases for which medicines cannot be claimed to cure or treat, such as cancer, AIDS, etc.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule O</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Disinfectants and Insecticides</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule R</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Standards for Cosmetics: Specifies standards for soaps, shampoos, creams, etc.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule W</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Drugs marketed under <span class=\"customMeta\" data-dictid=\"343b03419d169277718828bb100c95\">generic</span> names.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule X</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Narcotic and <span class=\"customMeta\" data-dictid=\"c773a2b6e81692777196cb811fd5d9\">Psychotropic</span> Substances</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Schedule Y</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Requirement and guidelines for import/manufacture or Clinical trials in India</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the true statement about the given dose-response curve.", "options": [{"label": "A", "text": "Drug C is the most potent", "correct": false}, {"label": "B", "text": "Drug B is the most efficacious", "correct": true}, {"label": "C", "text": "Drug C is as efficacious as drug D", "correct": false}, {"label": "D", "text": "Drug D is more potent than drug C", "correct": false}], "correct_answer": "B. Drug B is the most efficacious", "question_images": ["https://image.prepladder.com/notes/Hgci8fGLrxXzS80g7EUl1747395229.png"], "explanation_images": ["https://image.prepladder.com/notes/Hgci8fGLrxXzS80g7EUl1747395229.png"], "explanation": "<p>Correct Answer B - Drug B is the most efficaciou\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young man sustained a scorpion sting 2 hours ago. On examination, his blood pressure is 168/100 mm Hg; HR, 72 beats/minute and respiratory rate, 32 breaths/ minute. He also complains of breathlessness. How do you manage this patient?", "options": [{"label": "A", "text": "Metoprolol", "correct": false}, {"label": "B", "text": "Ivabradine", "correct": false}, {"label": "C", "text": "Prazosin", "correct": true}, {"label": "D", "text": "Frusemide", "correct": false}], "correct_answer": "C. Prazosin", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prazosin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alpha-1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> blocker</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Selectively blocks alpha-1 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors, leading to <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> and decreased blood pressure.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Benign prostatic hyperplasia</li>\n<li>Raynaud’s disease</li>\n<li>Scorpion Bite (DOC)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Postural hypotension</li>\n<li>Retrograde ejaculation</li>\n<li>Floppy <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> syndrome</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"af1cd978a41692777200da2f67bf22\">tachycardia</span> occurs due to vasodilation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following drugs in Column A with their contraindications in Column B. Column A Column B Morphine Amiodarone Vigabatrin Estrogen preparations QT prolongation Thromboembolism Pregnancy Haad injury", "options": [{"label": "A", "text": "A-1, B-3, C-2, D4", "correct": false}, {"label": "B", "text": "A-4, B-1,C-3, D-2", "correct": true}, {"label": "C", "text": "A-2, B-4, C-1, D-3", "correct": false}, {"label": "D", "text": "A-3, B-2, C-4, D-1", "correct": false}], "correct_answer": "B. A-4, B-1,C-3, D-2", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A hospital is conducting a study to check the efficacy of stains in multiple centers. There are 4-5 patients, and half of them receive the drug, and the other half receive the placebo. Neither the patients nor clinicians know which drug is being administered. What phase of the clinical trial describes the above scenario?", "options": [{"label": "A", "text": "Phase -1", "correct": false}, {"label": "B", "text": "Phase -3", "correct": true}, {"label": "C", "text": "Phase -2", "correct": false}, {"label": "D", "text": "Phase -4", "correct": false}], "correct_answer": "B. Phase -3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:723px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blind &amp; control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subjects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microdosing study</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2 - 5 healthy volunteers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Check the target binding and</strong> the <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> of the drug</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Human <span class=\"customMeta\" data-dictid=\"12cf5e696a169277719535c50b906c\">Pharmacology</span> and Safety</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20 - 50 healthy volunteers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To evaluate</p>\n<ul>\n<li>Drug safety- the most important</li>\n<li>MTD (maximum tolerable dose), <span class=\"customMeta\" data-dictid=\"00a5dcc74b16927771913b344e36a3\">loading</span> dose, and drug half-life.</li>\n<li>drug <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> (absorption, distribution, <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and excretion)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Therapeutic exploratory</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Randomized <span class=\"customMeta\" data-dictid=\"df216bc99216927771841f3321f8cb\">clinical trial</span> (RCT)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>200 - 500 patients</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To explore drug efficacy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Therapeutic Confirmatory</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Double-blinded RCT</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2000 - 5000 patients</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To Find the <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> drug dose and confirm its efficacy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Post-marketing Surveillance</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Larger population being treated on the approved drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>To Find hidden/missed/rare adverse effects.</li>\n<li>Evaluate compliance: long-term side effects</li>\n<li>Drug interactions &amp; Food interactions</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Anionic and weakly acidic drugs bind to which of the following?", "options": [{"label": "A", "text": "Albumin", "correct": true}, {"label": "B", "text": "Globulin", "correct": false}, {"label": "C", "text": "Lipoprotein", "correct": false}, {"label": "D", "text": "Alpha-1-glycoprotein", "correct": false}], "correct_answer": "A. Albumin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The table given below gives the AUC of Drug B alone and that of Drug B when given along with Drug A. If the p-value is &amp;lt; 0.01, which of the following statements is true? Drugs Area under curve B 570 seconds +/- 127 seconds B + A 820 seconds +/- 124 seconds", "options": [{"label": "A", "text": "Drug A decreases intestinal absorption of Drug B", "correct": false}, {"label": "B", "text": "Drug A reduces the first-pass metabolism of Drug B", "correct": true}, {"label": "C", "text": "Drug A increases the metabolism of Drug B", "correct": false}, {"label": "D", "text": "Drug A increases renal elimination of Drug B", "correct": false}], "correct_answer": "B. Drug A reduces the first-pass metabolism of Drug B", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false about the selection of essential drugs?", "options": [{"label": "A", "text": "An adequate safety profile needs to be established", "correct": false}, {"label": "B", "text": "Cost to benefit has to be considered", "correct": false}, {"label": "C", "text": "Fixed drug combination is preferred over single drugs", "correct": true}, {"label": "D", "text": "Disease prevalence is considered", "correct": false}], "correct_answer": "C. Fixed drug combination is preferred over single drugs", "question_images": [], "explanation_images": [], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ WHO criteria forthe selection of essential medicines are:</li><li>↳ Adequate data on the safety and efficacy of the drug must be available The drug should be available in a form where its quality and stability during storage is assured Choice of drugs depends on</li><li>↳ Adequate data on the safety and efficacy of the drug must be available</li><li>↳ The drug should be available in a form where its quality and stability during storage is assured</li><li>↳ Choice of drugs depends on</li><li>↳ Patterns of prevalent diseases Financial resources Availability of trained personnel and facilities Genetics, demography and environmental factors are also considered Cost-to-benefit ratio Pharmacokinetics of the drug Local manufacturing and storage facilities</li><li>↳ Patterns of prevalent diseases</li><li>↳ Financial resources</li><li>↳ Availability of trained personnel and facilities</li><li>↳ Genetics, demography and environmental factors are also considered</li><li>↳ Cost-to-benefit ratio</li><li>↳ Pharmacokinetics of the drug</li><li>↳ Local manufacturing and storage facilities</li><li>↳ Essential drugs should preferably be a single compound. The selection of essential drugs is a continuous process, and changes must be made with the development of public health and the availability of better drugs.</li><li>↳ Essential drugs should preferably be a single compound.</li><li>↳ The selection of essential drugs is a continuous process, and changes must be made with the development of public health and the availability of better drugs.</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who was diagnosed with epilepsy was put on Retigabine. Now phenytoin is being added. Which of the following changes should be made to Retigabine?", "options": [{"label": "A", "text": "Increase the dose", "correct": true}, {"label": "B", "text": "Decrease the dose", "correct": false}, {"label": "C", "text": "Stop the drug", "correct": false}, {"label": "D", "text": "Stop retigabine and start on Carbamazepine", "correct": false}], "correct_answer": "A. Increase the dose", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "If the dosage of a drug following first-order kinetics is doubled, how would it affect the half-life and plasma concentration?", "options": [{"label": "A", "text": "Half-life doubles, and plasma concentration remains the same", "correct": false}, {"label": "B", "text": "Half-life remains the sam,e and plasma concentration doubles", "correct": true}, {"label": "C", "text": "Half-life and plasma concentration remain the same", "correct": false}, {"label": "D", "text": "Half-life and plasma concentration doubles", "correct": false}], "correct_answer": "B. Half-life remains the sam,e and plasma concentration doubles", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ZUnVUpPc2oph9T3NOlB41747125310.png"], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p> </p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>First-order kinetics</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Zero-order kinetics</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Description</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>A constant fraction of the drug is eliminated per unit of time.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>A constant amount of the drug is eliminated per unit of time.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Rate of clearance</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Constant</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>More at lower concentrations and less at higher concentrations.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Half-life</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Constant</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Less at lower concentrations and more at higher concentrations.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Rate of elimination</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Proportional to its <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Independent of <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Examples</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Most of the drugs.</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Alcohol, aspirin, theophylline, tolbutamide, and warfarin.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient is on phenytoin for a seizure disorder. He was prescribed sucralfate four times a day for peptic ulcer. What should be the minimum duration of time between consumption of these drugs?", "options": [{"label": "A", "text": "30 minutes", "correct": false}, {"label": "B", "text": "60 minutes", "correct": false}, {"label": "C", "text": "90 minutes", "correct": false}, {"label": "D", "text": "120 minutes", "correct": true}], "correct_answer": "D. 120 minutes", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"3\" rowspan=\"1\">\n<p>Ulcer Protective Agents</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p> </p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Bismuth</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Sucralfate</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Properties</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Water-soluble, but precipitates when pH &lt;5</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Basic <span class=\"customMeta\" data-dictid=\"267416c084169277718117fb653ded\">aluminium</span> salt of sulfated sucrose. Polymerises at pH &lt;4, forming a sticky gel-like consistency.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Mechanism of Action</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Increases production of <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> mucosal <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> E, mucus, and bicarbonate.</li>\n<li>Precipitate <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> glycoproteins and coat the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> base.</li>\n<li>Detach and <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> <span class=\"customMeta\" data-dictid=\"313a9372811692777188be2ca0dedc\">Helicobacter</span> pylori directly.</li>\n</ul>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Precipitates surface proteins at the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> base, creating a physical barrier against acid, pepsin, and bile.</li>\n<li>Does not neutralise acid but delays <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> emptying.</li>\n<li>Potentially augments <span class=\"customMeta\" data-dictid=\"12347b15191692777188bc86d226e1\">gastric</span> mucosal <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> for additional protection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Dosage and Administration</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>120 mg taken half an hour before the three major meals and at bedtime for 4-8 weeks</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>1 <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">gram</span> taken on an empty stomach one hour before the three major meals and at bedtime for 4-8 weeks</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Side Effects</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Diarrhoea,</li>\n<li>Headache,</li>\n<li>Dizziness,</li>\n<li>Blackening of the tongue, dentures, and stools</li>\n</ul>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Constipation</li>\n<li>Hypophosphatemia</li>\n<li>Dry mouth</li>\n<li>Nausea</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Indications</p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>gastritis and non-ulcer <span class=\"customMeta\" data-dictid=\"906574b8861692777186f3a92513db\">dyspepsia</span> associated with H. pylori</li>\n<li>Occasionally used as part of a triple-drug regimen.</li>\n</ul>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Bile reflux, gastritis, and <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> of stress ulcers.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true about the dose-response curve?", "options": [{"label": "A", "text": "Drug B is the most efficacious", "correct": false}, {"label": "B", "text": "Drug B is the most potent", "correct": true}, {"label": "C", "text": "Drug C is more efficacious than drug D", "correct": false}, {"label": "D", "text": "Drug A is more potent than drug B", "correct": false}], "correct_answer": "B. Drug B is the most potent", "question_images": ["https://image.prepladder.com/content/vqEbprgVkHxCWoefsIN51747909299.png"], "explanation_images": ["https://image.prepladder.com/content/H8AVqzp8JHeQkqAjJZBN1747922392.png", "https://image.prepladder.com/content/qdPDi52GVQhqGF3BPLLl1747922415.png"], "explanation": "<p>Correct Answer B - Drug B is th\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In relation to drug absorption, what does the term \"extent\" signify?", "options": [{"label": "A", "text": "T max", "correct": false}, {"label": "B", "text": "Area under the curve", "correct": true}, {"label": "C", "text": "C max", "correct": false}, {"label": "D", "text": "t1/2", "correct": false}], "correct_answer": "B. Area under the curve", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following teratogenic drug with their teratogenic effects: Column A Column B Lithium Chloramphenicol Warfarin Thalidomide Phocomelia Depressed nasal bridge Gray baby syndrome Ebstein anomaly", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-d, 2-c, 3-b, 4-a", "correct": true}, {"label": "C", "text": "1-d, 2-a, 3-d, 4-c", "correct": false}, {"label": "D", "text": "1-c, 2-d, 3-a, 4-b", "correct": false}], "correct_answer": "B. 1-d, 2-c, 3-b, 4-a", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Teratogenic Disorder</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Warfarin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Fetal <span class=\"customMeta\" data-dictid=\"38d84b192c16927772023d96107e4c\">warfarin</span> syndrome</strong>: <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> hypoplasia, <span class=\"customMeta\" data-dictid=\"3d7836b47f1692777199a5bbfc749f\">stippled</span> epiphyses, limb hypoplasia, and central nervous system abnormalities.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Lithium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Ebstein's anomaly</strong><strong> </strong>(tricuspid <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> malformation).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p><strong>Thalidomide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Severe limb defects (<strong>phocomelia</strong>), ear, cardiac, and <span class=\"customMeta\" data-dictid=\"2fd33fb2ac16927771889901daadeb\">genitourinary</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Chloramphenicol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:bottom\">\n<p><strong>Gray Baby Syndrome</strong>: <span class=\"customMeta\" data-dictid=\"1665a40f1016927771801899eaed5d\">abdominal</span> distension</p>\n<p>cyanosis, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> distress, lethargy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Acitretin</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Craniofacial anomalies, heart defects, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Alcohol</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Fetal Alcohol Syndrome (growth retardation, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> anomalies, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> dysfunction, ASD, VSD).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>ACE inhibitors &amp; Angiotensin-receptor blockers</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Renal dysgenesis, oligohydramnios, lung hypoplasia, skull hypoplasia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Carbamazepine</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Neural tube defects (spina bifida), <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Isotretinoin<strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Craniofacial anomalies, heart defects, <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> malformations.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Carbimazole &amp; methimazole</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Choanal atresia, <span class=\"customMeta\" data-dictid=\"5dff4943631692777181b8974b302b\">aplasia</span> cutis, and <span class=\"customMeta\" data-dictid=\"f375a3584316927772020efa386e3e\">fetal</span> goitre.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Penicillamine</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Cutis laxa syndrome.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Statins</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Vertebral, anal, cardiac, tracheo-oesophageal fistula, renal, arterial, and limb defects (VACTERAL defects).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>SSRIs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Persistent <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> of the newborn.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Valproic acid<strong> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:middle\">\n<p>Neural tube defects (spina bifida), <span class=\"customMeta\" data-dictid=\"576134019e16927771859f4eac1021\">craniofacial</span> defects, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> malformations, and developmental delay.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding the clinical trials is correct?", "options": [{"label": "A", "text": "Phase 3 aim is to increase pharmacovigilance", "correct": false}, {"label": "B", "text": "Phase 4 is also called post marketing surveillance", "correct": true}, {"label": "C", "text": "Phase 3 is never double blinded", "correct": false}, {"label": "D", "text": "Phase 2 is done on healthy individuals", "correct": false}], "correct_answer": "B. Phase 4 is also called post marketing surveillance", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blind &amp; control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subjects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microdosing study</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2 - 5 healthy volunteers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Check the target binding and</strong> the <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> of the drug</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Human <span class=\"customMeta\" data-dictid=\"12cf5e696a169277719535c50b906c\">Pharmacology</span> and safety</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20 - 50 healthy volunteers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To evaluate</p>\n<ul>\n<li>Drug safety- the most important</li>\n<li>MTD (maximum tolerable dose), <span class=\"customMeta\" data-dictid=\"00a5dcc74b16927771913b344e36a3\">loading</span> dose, and drug half-life.</li>\n<li>drug <span class=\"customMeta\" data-dictid=\"a8683fba3b1692777195731bac4131\">pharmacokinetics</span> (absorption, distribution, <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> and excretion)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Therapeutic exploratory</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Randomized <span class=\"customMeta\" data-dictid=\"df216bc99216927771841f3321f8cb\">clinical trial</span> (RCT)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>200 - 500 patients</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To explore drug efficacy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Therapeutic Confirmatory</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Double-blinded RCT</p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2000 - 5000 patients</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To Find the <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> drug dose and confirm its efficacy</p>\n<p><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Post marketing Surveillance</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open-label trial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Larger population being treated on the approved drug</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>To Find hidden/missed/rare adverse effects.</li>\n<li>Evaluate compliance: long-term side effects</li>\n<li>Drug interactions &amp; Food interactions</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Phospholipase C acts via which of the following G proteins – coupled receptors?", "options": [{"label": "A", "text": "Gs", "correct": false}, {"label": "B", "text": "Gi", "correct": false}, {"label": "C", "text": "Gq", "correct": true}, {"label": "D", "text": "Go", "correct": false}], "correct_answer": "C. Gq", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G Protein Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effector</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Second Messenger(s)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gs</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cyclic <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases cAMP, activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gi</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adenylyl cyclase</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"1d84248e9f16927771850f8b75c26a\">cyclic</span> <span class=\"customMeta\" data-dictid=\"e040c51b2e1692777181f22b831de4\">AMP</span> (cAMP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases cAMP, inhibits protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> A (PKA)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Phospholipase C (PLC)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inositol trisphosphate (IP3) and DAG</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IP3 releases Ca2+ from ER; <span class=\"customMeta\" data-dictid=\"ffd1412fed1692777185cd107f3835\">DAG</span> activates protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> C (PKC)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Dorzolamide is a ………….?", "options": [{"label": "A", "text": "Topically applied sulfonamide antibacterial", "correct": false}, {"label": "B", "text": "Topical ocular carbonic anhydrase inhibitor", "correct": true}, {"label": "C", "text": "Second–generation sulfonylurea", "correct": false}, {"label": "D", "text": "Opioid receptor agonist", "correct": false}], "correct_answer": "B. Topical ocular carbonic anhydrase inhibitor", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is correct regarding the given graph?", "options": [{"label": "A", "text": "Drug 1 represents agonist and drug 2 represents inverse agonist", "correct": false}, {"label": "B", "text": "Drug 3 represents agonist and drug 4 represents inverse agonist", "correct": false}, {"label": "C", "text": "Drug 1 represents agonist and drug 4 represent inverse agonist", "correct": true}, {"label": "D", "text": "Drug 2 represents partial agonist and drug 3 represents inverse agonist", "correct": false}], "correct_answer": "C. Drug 1 represents agonist and drug 4 represent inverse agonist", "question_images": ["https://image.prepladder.com/notes/ZHLb1qiTh6kx6cbs4gWv1746708793.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of agonists</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Full <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> <strong>(Drug 1)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to <strong>produce an effect similar to the <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> signal molecule</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Partial <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> <strong>(Drug 2)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to produce a <strong>submaximal effect</strong> and can block the action of a<strong> full agonist.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inverse <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> <strong>(Drug 4)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It activates a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> to<strong> produce an effect opposite</strong> to that of an agonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neutral <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> <strong>(Drug 3)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It prevents the<strong> </strong><strong>action of an agonist</strong> on a <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> or the subsequent response but <strong>does not have any effect of its own. </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competitive antagonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Competes with agonists for the same binding site, reducing the <span class=\"customMeta\" data-dictid=\"2a93f2d9a11692777196928bd78855\">potency</span> of the agonist.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Non-competitive antagonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prevents the action of an <span class=\"customMeta\" data-dictid=\"7d8d28cda71692777180c89a3c86ce\">agonist</span> without competing with it for the binding s</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The manufacturer of a drug company labels a drug as having 500 mg of paracetamol. On quantitative analysis of the drug, it actually contained only 200 mg of paracetamol. What is this type of drug called?", "options": [{"label": "A", "text": "Spurious drug", "correct": false}, {"label": "B", "text": "Adulterated drug", "correct": false}, {"label": "C", "text": "Unethical drug", "correct": false}, {"label": "D", "text": "Misbranded drug", "correct": true}], "correct_answer": "D. Misbranded drug", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:674px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p><strong>Example</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Spurious Drugs</p>\n<p>(Counterfeit Drugs)</p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Have no active ingredient</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>500 mg <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> <span class=\"customMeta\" data-dictid=\"508e14a7ca16927772002140ece8fb\">tablet</span> → when checked, it contains no <span class=\"customMeta\" data-dictid=\"fcdd3383341692777194cf2cd4e400\">paracetamol</span> in it.</li>\n<li>Made by illegal people other than the manufacturer to copy the drug.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Misbranded Drugs</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Low-quality drugs</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>500 mg <span class=\"customMeta\" data-dictid=\"508e14a7ca16927772002140ece8fb\">tablet</span> → when checked, it contains only 200 mg.</li>\n<li>Made by the same manufacturer to increase profit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Adulterated Drugs</p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<p>Addition of harmful or unwanted excipients</p>\n</td>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #0d0d0d; border-right:1px solid #0d0d0d; border-top:1px solid #0d0d0d; vertical-align:top\">\n<ul>\n<li>Cough <span class=\"customMeta\" data-dictid=\"7cab9109cd16927771994c3125bd23\">syrup</span> made in India containing <span class=\"customMeta\" data-dictid=\"8e2fdef08316927771877389af9cc7\">ethylene</span> <span class=\"customMeta\" data-dictid=\"7451dcad4f1692777188609e12be1d\">glycol</span> → when checked, <span class=\"customMeta\" data-dictid=\"20fced1d1f1692777188cf8c607e50\">GMP</span> guidelines do not approve these substances.</li>\n<li>Ethylene <span class=\"customMeta\" data-dictid=\"7451dcad4f1692777188609e12be1d\">glycol</span> is harmful and not approved as an <span class=\"customMeta\" data-dictid=\"0925b97d4d16927771873ae9dcd02c\">excipient</span> by GMP.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The therapeutic index is used for assessing which of the following factors?", "options": [{"label": "A", "text": "Safety", "correct": true}, {"label": "B", "text": "Efficacy", "correct": false}, {"label": "C", "text": "Patency", "correct": false}, {"label": "D", "text": "Toxicity", "correct": false}], "correct_answer": "A. Safety", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - S\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following routes of administration will not bypass hepatic first-pass metabolism ?", "options": [{"label": "A", "text": "Sublingual", "correct": false}, {"label": "B", "text": "Oral", "correct": true}, {"label": "C", "text": "Intravenous", "correct": false}, {"label": "D", "text": "Transdermal", "correct": false}], "correct_answer": "B. Oral", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - O\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The technique given in the picture is used for:", "options": [{"label": "A", "text": "Synthesis of monoclonal antibodies", "correct": true}, {"label": "B", "text": "Preparing cell lines for viral culture", "correct": false}, {"label": "C", "text": "Synthesis of vaccines", "correct": false}, {"label": "D", "text": "Process of genetic engineering", "correct": false}], "correct_answer": "A. Synthesis of monoclonal antibodies", "question_images": ["https://image.prepladder.com/content/uhUMQKdAak0klZOxWTqZ1690778007.png"], "explanation_images": [], "explanation": "<p>Correct Option A - Synthesis of &lt;span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\"&gt;monoclonal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs does not increase the risk of bleeding in patients undergoing warfarin therapy ?", "options": [{"label": "A", "text": "Cimetidine", "correct": false}, {"label": "B", "text": "Carbamazepine", "correct": true}, {"label": "C", "text": "Isoniazid", "correct": false}, {"label": "D", "text": "Amiodarone", "correct": false}], "correct_answer": "B. Carbamazepine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - C\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Acetazolamide is given to a patient with glaucoma . It is a non-competitive inhibitor of the carbonic anhydrase enzyme . Which of the following would be the effect of this drug?", "options": [{"label": "A", "text": "Decrease in Vmax", "correct": true}, {"label": "B", "text": "Decrease in Km", "correct": false}, {"label": "C", "text": "Decrease in both Km and Vmax", "correct": false}, {"label": "D", "text": "No change in Vmax", "correct": false}], "correct_answer": "A. Decrease in Vmax", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Decrease in V\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What does a low apparent volume of distribution of a drug signify ?", "options": [{"label": "A", "text": "Low t ½", "correct": false}, {"label": "B", "text": "Low bioavailability", "correct": false}, {"label": "C", "text": "Low efficacy", "correct": false}, {"label": "D", "text": "Not extensively distributed to tissues", "correct": true}], "correct_answer": "D. Not extensively distributed to tissues", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Not extensively distributed to tissu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The loading dose of a drug is governed primarily by:", "options": [{"label": "A", "text": "Clearance", "correct": false}, {"label": "B", "text": "Volume of distribution", "correct": true}, {"label": "C", "text": "Plasma half-life", "correct": false}, {"label": "D", "text": "Bioavailability", "correct": false}], "correct_answer": "B. Volume of distribution", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Volume of distribu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following: Column A Column B 1. Omalizumab A. Anti-CD6 2. Itolizumab B. Anti-CD25 3. Daclizumab C. Anti-IgE 4. Belimumab D. Anti-IgG1 E. Anti-B lymphocyte stimulator", "options": [{"label": "A", "text": "1-C; 2-A; 3-B; 4-D", "correct": false}, {"label": "B", "text": "1-C; 2-D; 3-B; 4-E", "correct": false}, {"label": "C", "text": "1-C; 2-A; 3-D; 4-B", "correct": false}, {"label": "D", "text": "1-C; 2-A; 3-B; 4-E", "correct": true}], "correct_answer": "D. 1-C; 2-A; 3-B; 4-E", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - 1-C; 2-A; 3-B; 4-E:</p>\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\">\n<tbody>\n<tr>\n<td><strong>Column A</strong></td>\n<td><strong>Column B</strong></td>\n</tr>\n<tr>\n<td>1. Omalizumab</td>\n<td>C. Anti-IgE</td>\n</tr>\n<tr>\n<td>2. Itolizumab</td>\n<td>A. Anti-CD6</td>\n</tr>\n<tr>\n<td>3. Daclizumab</td>\n<td>B. Anti-CD25</td>\n</tr>\n<tr>\n<td>4. Belimumab</td>\n<td>E. Anti-B <span class=\"customMeta\" data-dictid=\"c605d4126116927771916c2002638e\">lymphocyte</span> stimulator</td>\n</tr>\n</tbody>\n\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\">\n<tbody>\n<tr>\n<td><strong>Omalizumab</strong></td>\n<td>Anti-IgE</td>\n</tr>\n<tr>\n<td><strong>Itolizumab</strong></td>\n<td>Anti-CD6</td>\n</tr>\n<tr>\n<td><strong>Daclizumab</strong></td>\n<td>Anti-CD25</td>\n</tr>\n<tr>\n<td><strong>Belimumab</strong></td>\n<td>Anti-B <span class=\"customMeta\" data-dictid=\"c605d4126116927771916c2002638e\">lymphocyte</span> stimulator</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "When the pH = pKa of a drug, which of the following statements is true ?", "options": [{"label": "A", "text": "Concentration of the drug is 50% ionic and 50% non-ionic", "correct": true}, {"label": "B", "text": "Concentration of the drug is 90% ionic and 10% non-ionic", "correct": false}, {"label": "C", "text": "Concentration of the drug is 75% ionic and 25% non-ionic", "correct": false}, {"label": "D", "text": "Concentration of the drug is 25% ionic and 75% non-ionic", "correct": false}], "correct_answer": "A. Concentration of the drug is 50% ionic and 50% non-ionic", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Concentration of the drug is 50% ionic and 50%\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please determine the therapeutic index of a medication based on the depicted dose-response curves .:", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "4", "correct": true}, {"label": "D", "text": "8", "correct": false}], "correct_answer": "C. 4", "question_images": ["https://image.prepladder.com/content/mibdo1D3IesQQvavXrGH1691506328.png"], "explanation_images": [], "explanation": "<p>Correct Option C - 4\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A dermatologist wants to prescribe acitretin to a patient with psoriasis . Which of the following statements is false regarding the drug?", "options": [{"label": "A", "text": "Contraindicated in persons with hyperlipidemia", "correct": false}, {"label": "B", "text": "It can cause increased sensitivity to sunlight", "correct": false}, {"label": "C", "text": "Female patients should avoid getting pregnant for 6 months after therapy", "correct": true}, {"label": "D", "text": "Acitretin has a half life of about 50 hours", "correct": false}], "correct_answer": "C. Female patients should avoid getting pregnant for 6 months after therapy", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Female patients should avoid getting pregnant for 6 months after th\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Drug Classification</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Retinoids</p>\n</td>\n<td>\n<p>Isotretinoin, Acitretin</p>\n</td>\n<td>\n<p>Used to treat <span class=\"customMeta\" data-dictid=\"8b61bc6e361692777180695ac33e91\">acne</span> and other <span class=\"customMeta\" data-dictid=\"193e0fc1471692777186c661338b8e\">dermatological</span> conditions.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>ACE inhibitors</p>\n</td>\n<td>\n<p>Lisinopril, Enalapril</p>\n</td>\n<td>\n<p>Used to treat <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> and heart failure.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Anticoagulants</p>\n</td>\n<td>\n<p>Warfarin, Heparin</p>\n</td>\n<td>\n<p>Used to prevent or treat blood <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> disorders.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Thalidomide and analogs</p>\n</td>\n<td>\n<p>Thalidomide</p>\n</td>\n<td>\n<p>Previously used as a <span class=\"customMeta\" data-dictid=\"dd4bbf3a1a16927771988e61c3d5e9\">sedative</span> and caused severe birth defects.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Lithium</p>\n</td>\n<td>\n<p>Lithium carbonate</p>\n</td>\n<td>\n<p>Used to treat <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> disorder and depression.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Androgens</p>\n</td>\n<td>\n<p>Testosterone</p>\n</td>\n<td>\n<p>Used in hormone replacement therapy and hypogonadism.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which phase of a clinical trial is primarily focused on assessing the preliminary efficacy and determining the optimal dose of a drug?", "options": [{"label": "A", "text": "Phase 1", "correct": false}, {"label": "B", "text": "Phase 2", "correct": true}, {"label": "C", "text": "Phase 3", "correct": false}, {"label": "D", "text": "Phase 4", "correct": false}], "correct_answer": "B. Phase 2", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/hrsSwRp13Mxt5nYIGdJa1724844502.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Apparent volume of distribution of a drug is very high (6L/kg) . Which of the following is true regarding the distribution of that drug ?", "options": [{"label": "A", "text": "Highly bound to plasma proteins", "correct": false}, {"label": "B", "text": "Confined to vascular compartment", "correct": false}, {"label": "C", "text": "Sequestered in body tissues", "correct": true}, {"label": "D", "text": "Both A and B", "correct": false}], "correct_answer": "C. Sequestered in body tissues", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Sequestered in body tissu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "You, being an ardent researcher in the field of vaccine production, are the in-charge of preparing samples to make a vaccine against the new variant of SARS-CoV 2. After getting satisfactory results in preclinical studies, you seek approval to do clinical studies, which requires healthy volunteers. Which of the following phases does this refer to?", "options": [{"label": "A", "text": "Phase 1", "correct": true}, {"label": "B", "text": "Phase 2", "correct": false}, {"label": "C", "text": "Phase 3", "correct": false}, {"label": "D", "text": "Phase 4", "correct": false}], "correct_answer": "A. Phase 1", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Find therapeutic index of a drug from the information given below: LD 50: 400 ED 50: 100", "options": [{"label": "A", "text": "1", "correct": false}, {"label": "B", "text": "2", "correct": false}, {"label": "C", "text": "4", "correct": true}, {"label": "D", "text": "8", "correct": false}], "correct_answer": "C. 4", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - 4\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following can result in gynaecomastia except ?", "options": [{"label": "A", "text": "Liver failure", "correct": false}, {"label": "B", "text": "Spironolactone", "correct": false}, {"label": "C", "text": "Digoxin", "correct": false}, {"label": "D", "text": "Aromatase inhibitors", "correct": true}], "correct_answer": "D. Aromatase inhibitors", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"b249ba1c6a16927771821b83b1fd9b\"&gt;Aromatase&lt;/span&gt; inh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medications exhibit zero order kinetics among the options provided?", "options": [{"label": "A", "text": "Phenytoin", "correct": true}, {"label": "B", "text": "Epinephrine", "correct": false}, {"label": "C", "text": "Morphine", "correct": false}, {"label": "D", "text": "Propranolol", "correct": false}], "correct_answer": "A. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ph\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td style=\"text-align:center\">\n<p><strong>Kinetic Type</strong></p>\n</td>\n<td style=\"text-align:center\">\n<p><strong>Zero-Order Kinetics </strong></p>\n</td>\n<td style=\"text-align:center\">\n<p><strong>First-Order Kinetics</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Rate of Elimination </p>\n</td>\n<td>\n<p>Constant amount of drug is eliminated per unit of time </p>\n</td>\n<td>\n<p>Constant fraction of drug is eliminated per unit of time based on concentration </p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Drug Concentration </p>\n</td>\n<td>\n<p>Does not affect the rate of elimination</p>\n</td>\n<td>\n<p>affects the rate of elimination</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Graphical Representation </p>\n</td>\n<td>\n<p>Straight line with a constant slope on a <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> concentration vs time plot </p>\n</td>\n<td>\n<p>Exponential decrease on a semi-logarithmic concentration vs time plot </p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Half-Life </p>\n</td>\n<td>\n<p>Not constant, as it depends on the initial drug amount </p>\n</td>\n<td>\n<p>Constant, as it is independent of the drug concentration </p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Factors Affecting Kinetics </p>\n</td>\n<td>\n<p>Enzyme saturation, limited capacity for <span class=\"customMeta\" data-dictid=\"557488ca4a1692777186befe1edb06\">drug metabolism</span> or elimination </p>\n</td>\n<td>\n<p>Enzyme activity, drug concentration, and factors affecting <span class=\"customMeta\" data-dictid=\"557488ca4a1692777186befe1edb06\">drug metabolism</span> or elimination</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Examples </p>\n</td>\n<td>\n<p>Phenytoin, <span class=\"customMeta\" data-dictid=\"f0705db1901692777187acdc0f9e24\">Ethanol</span> (at high concentrations) </p>\n</td>\n<td>\n<p> Morphine, Propranolol </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drugs are subjected to therapeutic drug monitoring?", "options": [{"label": "A", "text": "Phenytoin", "correct": true}, {"label": "B", "text": "Heparin", "correct": false}, {"label": "C", "text": "Aspirin", "correct": false}, {"label": "D", "text": "Metformin", "correct": false}], "correct_answer": "A. Phenytoin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Aspirin and phenobarbitone are acidic drugs whereas diazepam is a basic drug , mark the false statement about these drugs:", "options": [{"label": "A", "text": "Aspirin is present in mainly non – ionized form in stomach, hence can be easily absorbed", "correct": false}, {"label": "B", "text": "Diazepam is mostly absorbed from intestine", "correct": false}, {"label": "C", "text": "Phenobarbitone can be absorbed from the stomach.", "correct": false}, {"label": "D", "text": "Diseases decreasing the transit time of drugs like diarrhea will increase the drug absorption in the small intestine", "correct": true}], "correct_answer": "D. Diseases decreasing the transit time of drugs like diarrhea will increase the drug absorption in the small intestine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Diseases decreasing the &lt;span class=\"customMeta\" data-dictid=\"5aa2a98f8e1692777200beac5d7e69\"&gt;transit time&lt;/span&gt; of drugs like diarrhoea will increase the drug &lt;span class=\"customMeta\" data-dictid=\"5fcb9396d1169277718069dd7fa788\"&gt;absorption&lt;/span&gt; in the small intestine.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 89 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is not responsible for teratogenicity due to thalidomide?", "options": [{"label": "A", "text": "Release of reactive oxygen species and free radicals", "correct": false}, {"label": "B", "text": "Suppression of angiogenesis", "correct": false}, {"label": "C", "text": "Cereblon binding", "correct": false}, {"label": "D", "text": "Inhibition of IL2, IL4, IL5", "correct": true}], "correct_answer": "D. Inhibition of IL2, IL4, IL5", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not an immune checkpoint inhibitor?", "options": [{"label": "A", "text": "Nivolumab", "correct": false}, {"label": "B", "text": "Pembrolizumab", "correct": false}, {"label": "C", "text": "Atezolimumab", "correct": false}, {"label": "D", "text": "Cetuximab", "correct": true}], "correct_answer": "D. Cetuximab", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/bcIAwAdbIAEfmEkX2r991745386983.png", "https://image.prepladder.com/notes/FEX0FEgzkdi0lw512ejW1745387214.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the mechanism of action of cyclosporine?", "options": [{"label": "A", "text": "Inhibition of calcinuerin", "correct": true}, {"label": "B", "text": "Amp kinase stimulation", "correct": false}, {"label": "C", "text": "IMP dehydrogenase inhibitions", "correct": false}, {"label": "D", "text": "Dihydro-orotate dehydrogenase inhibitor", "correct": false}], "correct_answer": "A. Inhibition of calcinuerin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\"&gt;Inhibition&lt;/span&gt; of &lt;span class=\"customMeta\" data-dictid=\"746f157681169277718323a004b1d4\"&gt;calcineurin&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cyclosporine</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Binds to cyclophilin, a protein that is expressed in T-cells, and this complex then binds to and inhibits calcineurin</li>\n<li>It results in a <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> <span class=\"customMeta\" data-dictid=\"739aa4b5ea1692777200a636ee075f\">transcription</span> of <span class=\"customMeta\" data-dictid=\"0ac01cc0c31692777185cae5f28175\">cytokine</span> genes for IL-2, TNF-alpha, IL-3, IL-4, CD40L and Granulocyte-macrophage colony-stimulating factors and interferon-gamma</li>\n<li>Ultimately, this results in a reduction in T-cell <span class=\"customMeta\" data-dictid=\"8eedb6cec61692777196a6a3b93d3f\">proliferation</span> - <span class=\"customMeta\" data-dictid=\"498d3df3a416927771894f595a597a\">Immunosuppression</span> and immunomodulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Post-solid organ <span class=\"customMeta\" data-dictid=\"ee9f07b0a81692777200e416e4e5d7\">transplantation</span> - to avoid organ rejection</li>\n<li>Rheumatoid arthritis, which has not responded to methotrexate</li>\n<li>Amyotrophic <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> sclerosis</li>\n<li>Steroid resistant Foca segental glomerulosclerosis</li>\n<li>Psoriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adverse effect </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reduced GFR</li>\n<li>Hypomagnesemia</li>\n<li>Hyperkalemia</li>\n<li>Dyslipidemia</li>\n<li>Gynecomastia</li>\n<li>Hypertrichosis</li>\n<li>Neurotoxicity - convulsion</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 13 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A drug solution containing 500 mg/5 ml of the drug is given to you. You are provided with a 2 ml syringe (having 10 divisions for each ml). How many divisions of the 2 ml syringe need to be administered to deliver 180 mg of the drug to a patient?", "options": [{"label": "A", "text": "1.8", "correct": false}, {"label": "B", "text": "10", "correct": false}, {"label": "C", "text": "14", "correct": false}, {"label": "D", "text": "18", "correct": true}], "correct_answer": "D. 18", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D. \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 11 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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His blood pressure is consistently elevated despite being on multiple antihypertensive medications. Laboratory tests reveal elevated plasma aldosterone concentration and suppressed plasma renin activity. A CT scan of the abdomen shows an adrenal adenoma. Which is the most appropriate pharmacologic treatment for this patient's condition?", "options": [{"label": "A", "text": "Lisinopril", "correct": false}, {"label": "B", "text": "Hydrochlorothiazide", "correct": false}, {"label": "C", "text": "Amlodipine", "correct": false}, {"label": "D", "text": "Spironolactone", "correct": true}], "correct_answer": "D. Spironolactone", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NLOUOOoMT7NacaeI4yPb1748077358.mp3", "video": ""}, {"text": "Which of the following drugs is not used in the treatment of central diabetes insipidus?", "options": [{"label": "A", "text": "Carbamazepine", "correct": false}, {"label": "B", "text": "Desmopressin", "correct": false}, {"label": "C", "text": "Chlorpropamide", "correct": false}, {"label": "D", "text": "Indomethacin", "correct": true}], "correct_answer": "D. Indomethacin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nm11Z6wd6STSB26hQoOB1745661836.mp3", "video": ""}, {"text": "A 68-year-old patient presents with symptoms of lethargy, nausea, and muscle cramps. laboratory tests reveal hyponatremia and plasma hypoosmolality. He has a history of lung cancer and was recently started on selective serotonin reuptake inhibitors (SSRIs) for depression. He is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following statements regarding the management of SIADH is incorrect?", "options": [{"label": "A", "text": "Fluid restriction to less than 800ml/day is the first-line treatment for Mild to Moderate SIADH.", "correct": false}, {"label": "B", "text": "Severe SIADH is corrected with administration of 100 ml iv bolus of 3% NaCl", "correct": false}, {"label": "C", "text": "Targeted sodium correction should be &amp;gt;1mEq/L per hour in case of severe SIADH", "correct": true}, {"label": "D", "text": "Demeclocycline and lithium can be used in the treatment of mild to moderate SIADH.", "correct": false}], "correct_answer": "C. Targeted sodium correction should be &gt;1mEq/L per hour in case of severe SIADH", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severity of SIADH</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Asymptomatic, Mild lethargy, nausea</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fluid Restriction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pronounced Lethargy, Confusion, Cramps, <span class=\"customMeta\" data-dictid=\"9a8412e39e1692777193c550a5dbb4\">Nausea</span> and Vomiting</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fluid Restriction, Loop Diuretics, <span class=\"customMeta\" data-dictid=\"699f9aa3cf1692777201b501b79deb\">Vasopressin</span> Antagonists(VAPTANS), Demeclocycline, Lithium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe symptoms (e.g., severe confusion, seizures, coma)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertonic saline, fluid restriction, <span class=\"customMeta\" data-dictid=\"699f9aa3cf1692777201b501b79deb\">Vasopressin</span> Antagonist</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XcSfuZ39ExxVLLmnNi9X1748078692.mp3", "video": ""}, {"text": "Which of the following is the incorrect statement with respect to vasopressin inhibitors?", "options": [{"label": "A", "text": "Conivaptan is used only as an intravenous formulation for hospitalised patients of hypovolemic/euvolemic hyponatremia.", "correct": false}, {"label": "B", "text": "Tolvaptan is given a black box warning and is intended to be given under close monitoring of serum Na+", "correct": false}, {"label": "C", "text": "Osmotic demyelination syndrome is one of the serious adverse effects of the usage of vasopressin antagonists.", "correct": false}, {"label": "D", "text": "Tolvaptan is a non-selective V1/V2 antagonist, while conivaptan is a selective V2 antagonist", "correct": true}], "correct_answer": "D. Tolvaptan is a non-selective V1/V2 antagonist, while conivaptan is a selective V2 antagonist", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Y1fA7PgEzApTOhnm0MHS1748078395.mp3", "video": ""}, {"text": "A 7-year-old child presents with a history of bed-wetting three to four times a week. The child has no significant medical history and physical examination is normal. Which of the following is an incorrect statement with respect to initial management for nocturnal enuresis in this child?", "options": [{"label": "A", "text": "The drug of choice for nocturnal enuresis is intranasal desmopressin, administered at bedtime.", "correct": true}, {"label": "B", "text": "Primary nocturnal enuresis is the most common type where the child has never developed bladder control.", "correct": false}, {"label": "C", "text": "Initial management, in this case, is reducing water intake in the evening and doing bladder exercises.", "correct": false}, {"label": "D", "text": "Allergic reactions similar to urticaria or anaphylaxis can occur due to desmopressin administration.", "correct": false}], "correct_answer": "A. The drug of choice for nocturnal enuresis is intranasal desmopressin, administered at bedtime.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dEeq1LE6Pv5069JFGqoX1748078167.mp3", "video": ""}, {"text": "A 42-year-old patient, previously operated on for pituitary adenoma, was diagnosed with post-operative central diabetes insipidus. All of the following are true regarding the drug of choice for this patient, except?", "options": [{"label": "A", "text": "The drug acts on V1 Receptor located in renal tubules", "correct": true}, {"label": "B", "text": "The preferred route is intranasal, as the drug is metabolised by trypsin in the gut", "correct": false}, {"label": "C", "text": "Cerebral oedema can occur as a serious adverse effect of this drug", "correct": false}, {"label": "D", "text": "The drug is contraindicated in patients with acute renal failure", "correct": false}], "correct_answer": "A. The drug acts on V1 Receptor located in renal tubules", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Receptor Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>G Subtype</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Actions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>V1 (V1a)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vascular smooth muscle, liver, CNS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vasoconstriction, glycogenolysis, <span class=\"customMeta\" data-dictid=\"e7032bae7f1692777195d693722e54\">platelet</span> aggregation, GIT smooth muscle constriction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>V2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Renal collecting ducts</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase water reabsorption</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>V3 (V1b)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gq</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior pituitary, Pancreas, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">Adrenal</span> Medulla</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Release of ACTH</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/o1r1Ae0pkal30Xw2fBNP1748077957.mp3", "video": ""}, {"text": "A 55-year-old man with a history of alcoholic cirrhosis presents with progressively worsening abdominal distention, decreased urine output, and swelling in his legs. On examination, his abdomen is tense and distended with caput medusa and ascites, and his chest shows spider angioma. Laboratory tests reveal elevated serum creatinine levels. Which of the following is the drug of choice for this patient?", "options": [{"label": "A", "text": "Terlipressin", "correct": true}, {"label": "B", "text": "Spironolactone", "correct": false}, {"label": "C", "text": "Furosemide", "correct": false}, {"label": "D", "text": "Lactulose", "correct": false}], "correct_answer": "A. Terlipressin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FO67RN9jc0ruq6lKsrqB1748001732.mp3", "video": ""}, {"text": "A 7-year-old child presents with persistent bedwetting despite implementing various lifestyle modifications, such as reducing fluid intake before bedtime and establishing a regular toileting schedule. Which of the following would be the appropriate drug of choice for this child?", "options": [{"label": "A", "text": "Terlipressin", "correct": false}, {"label": "B", "text": "Felypressin", "correct": false}, {"label": "C", "text": "Desmopressin", "correct": true}, {"label": "D", "text": "Octreotide", "correct": false}], "correct_answer": "C. Desmopressin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Vasopressin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>G Protein</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Second messenger</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Location</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V1 (V1A)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Gq type</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increase IP3/DAG</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Vasoconstriction, Increase BP.</p>\n<p>It can be used in the treatment of shock.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Smooth muscle cells of blood vessels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Gs type</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increase cAMP</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"0327d20161169277720287847fa436\">vWF</span> and Factor 8 (present in endothelial cells of blood vessels and nephron)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"3f961706a01692777181011d842df8\">aquaporin</span> II on collecting ducts (Reabsorb water from urine)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V3 (V1B)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Gq type</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increase IP3/DAG</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"55fd11666f1692777180e80135bda8\">ACTH</span> and endorphins (stress hormone)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Present in brain neurons (a neuropeptide)</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Property</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Terlipressin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Felypressin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Desmopressin</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Receptor</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V1 agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V1 agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>V2 agonist</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Injections only</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Injections only</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Orally, Nasally</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Control <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> in <span class=\"customMeta\" data-dictid=\"192677035a169277718780b4d6dbbb\">esophageal</span> varices</p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Add-on to local anaesthetic</p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Treatment of <span class=\"customMeta\" data-dictid=\"904d77ba8a16927771882396edef7c\">Hemophilia</span> A.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p> </p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p>Hepatorenal syndrome (DOC)</p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p> </p>\n<p>Epinephrine alternative</p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p>Nocturnal <span class=\"customMeta\" data-dictid=\"cee73226fd169277718733280d8517\">enuresis</span> (bed wetting).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p>Resistant shock</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:bottom\">\n<p>Neurogenic <span class=\"customMeta\" data-dictid=\"aabafbc36d16927771861d9dae54ed\">diabetes insipidus</span> (DOC).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wlmlsTv2BmdCfZZEwo441748077646.mp3", "video": ""}, {"text": "A 55-year-old patient presents following a severe head injury. On examination, the patient is unconscious with signs of increased intracranial pressure (ICP). A CT scan reveals significant cerebral oedema and brain mass effect. The patient is scheduled for an emergency neurosurgery. Which medication is most appropriate for reducing cerebral oedema before and after the surgery in this patient?", "options": [{"label": "A", "text": "Loop diuretics", "correct": false}, {"label": "B", "text": "Thiazide diuretics", "correct": false}, {"label": "C", "text": "Osmotic diuretics", "correct": true}, {"label": "D", "text": "Carbonic anhydrase inhibitors", "correct": false}], "correct_answer": "C. Osmotic diuretics", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7e1xn1NXbIcrfI6DOozp1748077475.mp3", "video": ""}, {"text": "A 70-year-old female with chronic heart failure is being treated with a diuretic to manage her symptoms of fluid overload. Recently, she has started to experience hearing loss and ringing in her ears. On reviewing her medications, which class of diuretics is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Thiazide diuretics", "correct": false}, {"label": "B", "text": "Osmotic diuretics", "correct": false}, {"label": "C", "text": "Carbonic anhydrase inhibitors", "correct": false}, {"label": "D", "text": "Loop diuretics", "correct": true}], "correct_answer": "D. Loop diuretics", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qYkLhpOARMWl2vGZayZD1736440413.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> tubule, decreasing <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetazolamide, Methazolamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Angle <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> Glaucoma, Altitude sickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolic acidosis, Hypokalemia, hyperammonemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. <span class=\"customMeta\" data-dictid=\"1848b160c11692777191b60caaf622\">Loop diuretics</span> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit the Na-K-2Cl <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> in the thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Furosemide, Bumetanide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, Chronic heart failure, Hypercalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, <strong>Ototoxicity, </strong>Metabolic alkalosis,</p>\n<p>Hyperglycemia,</p>\n<p>Hyperuricemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. <span class=\"customMeta\" data-dictid=\"74c7df38ec169277720012966920d9\">Thiazide</span> diuretics (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydrochlorothiazide, Chlorthalidone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, Edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, Hyponatremia,</p>\n<p>Hyperglycemia ,Hyperuricemia</p>\n<p>, metabolic alkalosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. Potassium-sparing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium channels in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"32562f5afa1692777193c891837db9\">nephron</span> or block <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spironolactone, Amiloride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure, Hyperaldosteronism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperkalemia, <span class=\"customMeta\" data-dictid=\"78cd34126d16927771887bf6b44cf6\">Gynecomastia</span> (for Spironolactone)</p>\n<p>,metabolic acidosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. <span class=\"customMeta\" data-dictid=\"3dfad720dd169277719417acbd5acc\">Osmotic diuretics</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"612769eab6169277719463af223927\">osmolarity</span> of the <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtrate, inhibiting water reabsorption.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mannitol, Glycerin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cerebral oedema, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> glaucoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dehydration, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">Electrolyte</span> imbalance</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3xrob4n0KwZUMSrijaAh1748075357.mp3", "video": ""}, {"text": "A patient on long-term lithium therapy visits with complaints of frequent urination and increased thirst. He was diagnosed with nephrogenic diabetes insipidus (DI) based on urine analysis and plasma ADH levels. He was prescribed a combination of amiloride and hydrochlorothiazide. What is the reason for the use of thiazide diuretics in nephrogenic DI?", "options": [{"label": "A", "text": "Thiazides reduce urine output by increasing free water absorption in proximal tubules", "correct": true}, {"label": "B", "text": "Thiazides directly increase the sensitivity of the kidneys to ADH.", "correct": false}, {"label": "C", "text": "Thiazides help to increase lithium excretion, reducing its nephrotoxic effects.", "correct": false}, {"label": "D", "text": "Thiazides decrease the risk of hypokalemia when used with amiloride.", "correct": false}], "correct_answer": "A. Thiazides reduce urine output by increasing free water absorption in proximal tubules", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thiazide diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Induce mild volume <span class=\"customMeta\" data-dictid=\"7061e0e0051692777186ba9c5f27df\">depletion</span> → ↑ <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> <span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\">tubular</span> <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of water → ↓ <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> output</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amiloride</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blocks ENaC channels in collecting ducts → ↓ <span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\">lithium</span> <span class=\"customMeta\" data-dictid=\"cc20d2d7111692777201fb0caeb3f2\">uptake</span> → <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> protection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lithium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causes <span class=\"customMeta\" data-dictid=\"8544e173991692777193d9a5472b4f\">nephrogenic</span> <span class=\"customMeta\" data-dictid=\"7194dbeaed1692777186e2554f8ebf\">DI</span> by damaging ADH-sensitive pathways in collecting ducts</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7IQzc1ZsQw7JKrUaikGG1747295729.mp3", "video": ""}, {"text": "Which of the following statements is true with respect to thiazides and loop diuretics?", "options": [{"label": "A", "text": "Thiazides are preferred over loop diuretics in hypertensive patients with low GFR.", "correct": false}, {"label": "B", "text": "Thiazides cause indirect vasodilatation by prostaglandin release, unlike loop diuretics", "correct": false}, {"label": "C", "text": "Thiazides are preferred over loop diuretics in patients with osteoporosis", "correct": true}, {"label": "D", "text": "Thiazides will not cause hypokalemia, unlike loop diuretics", "correct": false}], "correct_answer": "C. Thiazides are preferred over loop diuretics in patients with osteoporosis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8Lru9j4b8B2qKc1VWVsV1748076345.mp3", "video": ""}, {"text": "A 56-year-old chronic hypertensive who hasn't taken his medication in the past three days presents with an acute severe headache, blurry vision, palpitations, and diaphoresis. On examination, blood pressure is 240/140 mm Hg. Which of the following is the ideal drug of choice for this patient?", "options": [{"label": "A", "text": "Furosemide", "correct": true}, {"label": "B", "text": "Chlorthalidone", "correct": false}, {"label": "C", "text": "Acetazolamide", "correct": false}, {"label": "D", "text": "Mannitol", "correct": false}], "correct_answer": "A. Furosemide", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diuretic Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\" style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thiazide - <span class=\"customMeta\" data-dictid=\"184759c019169277718462fb8043bf\">Chlorothiazide</span> <strong>(Option B)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HTN (effective in <span class=\"customMeta\" data-dictid=\"5297b5833216927771910b7a85de53\">low-grade</span> HTN)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:top\">\n<p>It is not for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> fluid <span class=\"customMeta\" data-dictid=\"9d02a99d051692777194aa3375023b\">overload</span> but can be used as an adjunct</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">Anhydrase</span> Inhibitors - <span class=\"customMeta\" data-dictid=\"bd1418cfce1692777180087a9f293c\">Acetazolamide</span> <strong>(Option C) </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma, altitude sickness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> or fluid overload</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:top\">\n<p>Osmotic Diuretics - <span class=\"customMeta\" data-dictid=\"67ba030b801692777191d63dce44b4\">Mannitol</span> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-left:1px solid #000000; border-right:1px solid #000000; vertical-align:top\">\n<p>Reducing <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/laYQVxDKo8OMmKrKZZcY1748076111.mp3", "video": ""}, {"text": "A patient with chronic renal failure and resistant oedema was treated with a drug that alleviated the oedema. However, increasing doses were needed over time. Although the drug remained effective, the patient developed involuntary hand twitching and perioral numbness. Which class of drug was given?", "options": [{"label": "A", "text": "Loop diuretics", "correct": true}, {"label": "B", "text": "Carbonic anhydrase inhibitors", "correct": false}, {"label": "C", "text": "Thiazide diuretics", "correct": false}, {"label": "D", "text": "Osmotic diuretics", "correct": false}], "correct_answer": "A. Loop diuretics", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/0XoO0kAFMqmFy38y2nzJ1736440699.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gQ6Ov7PSlqrOgq4EPf9N1745661583.mp3", "video": ""}, {"text": "A 32-year-old mountain climber presents to the base camp complaining of severe headache, nausea, and fatigue after ascending rapidly to a high altitude. On examination, his respiratory rate is increased, and arterial blood gas analysis shows decreased partial pressure of carbon dioxide (PaCO2). Given the Acute Mountain Sickness (AMS) suspicion, acetazolamide is administered to alleviate symptoms. Which of the following best describes acetazolamide's primary mechanism of action in treating AMS?", "options": [{"label": "A", "text": "Metabolic Acidosis", "correct": true}, {"label": "B", "text": "Respiratory Alkalosis", "correct": false}, {"label": "C", "text": "Respiratory Acidosis", "correct": false}, {"label": "D", "text": "Metabolic Alkalosis", "correct": false}], "correct_answer": "A. Metabolic Acidosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8uwqslX3Wiym4aFBKmx31736440611.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Change</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High altitude effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>↓ PaO₂ → ↑ <span class=\"customMeta\" data-dictid=\"a58f1f33f81692777201ad5e0d60ca\">ventilation</span> → ↓ PaCO₂ → <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">Respiratory</span> alkalosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetazolamide effect</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> → ↑ HCO₃⁻ excretion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acid–base result</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic acidosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical outcome</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stimulates respiration, ↓ AMS symptoms</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Y7eIGK2cycg3aO8sdEgi1748075980.mp3", "video": ""}, {"text": "All of the following are preferred uses of acetazolamide, except?", "options": [{"label": "A", "text": "Uric acid kidney stones", "correct": false}, {"label": "B", "text": "Mountain sickness", "correct": false}, {"label": "C", "text": "Pulmonary hypertension", "correct": true}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "C. Pulmonary hypertension", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medication and uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glaucoma (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA:</strong> Reduces <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> from <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> cells</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Eye Drops: </strong>Brinzolamide, Dorzolamide\n\t\t\t\t<ul>\n<li>Use: Primary open-angle glaucoma</li>\n</ul>\n</li>\n<li><strong>IV Drugs:</strong> Acetazolamide\n\t\t\t\t<ul>\n<li>Use: Emergency treatment for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> congestive glaucoma</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alkalinisation of Urine</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA:</strong> <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of bicarbonate</p>\n\t\t\t \n\n\t\t\t<p><strong>Side Effects: </strong></p>\n<ul>\n<li>Higher risk of <span class=\"customMeta\" data-dictid=\"b95c7f7b821692777181df660ee7ff\">alkaline</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> stones</li>\n<li>Increased risk of <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> <span class=\"customMeta\" data-dictid=\"189b6fc834169277719580eb39bb4c\">phosphate</span> stones</li>\n</ul>\n<p><strong>Treatment:</strong></p>\n<ul>\n<li>Thiazide diuretics: Reduce <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> excretion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Useful for <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> drug poisoning</li>\n<li>Effective against <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> stones, including <strong>uric acid stones (Option A)</strong> and <span class=\"customMeta\" data-dictid=\"c65131cb591692777185e8b4d0055f\">cystine</span> stones (associated with homocystinuria)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic Acidosis in Blood (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Condition: Elevated levels of H+ ions in the blood</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treatment: Acetazolamide is the drug of choice for <span class=\"customMeta\" data-dictid=\"0fe458146b16927771923e5742e418\">mountain sickness</span> (especially <strong>HAPE-High Altitude <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">Pulmonary</span> Edema</strong>)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epilepsy </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Suppresses the activity of neurons</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acetazolamide was earlier used for epilepsy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Periodic</strong></p>\n<p><strong>muscle paralysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Imbalance of <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> <span class=\"customMeta\" data-dictid=\"4b2f2a6d0a16927771902f60fa9ff7\">ion</span> in blood</li>\n<li>Occurs due to Hyperkalemia, Hypokalemia</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acetazolamide is used in<strong> <span class=\"customMeta\" data-dictid=\"53ddc0755c1692777195e8d5f9fc68\">periodic</span> muscle paralysis.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vZRLflzXUEQTNqT4rtZM1748075683.mp3", "video": ""}, {"text": "A 45-year-old man who has been treated for glaucoma comes with complaints of muscle weakness, fatigue, and palpitations. Laboratory tests reveal significant hypokalemia and metabolic acidosis. Which class of diuretics is most likely responsible for these symptoms, considering the maximum loss of potassium?", "options": [{"label": "A", "text": "Loop diuretics", "correct": false}, {"label": "B", "text": "Thiazide diuretics", "correct": false}, {"label": "C", "text": "Osmotic diuretics", "correct": false}, {"label": "D", "text": "Carbonic anhydrase inhibitors", "correct": true}], "correct_answer": "D. Carbonic anhydrase inhibitors", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:720px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors (Option C)</strong></li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> tubule, decreasing <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetazolamide, Methazolamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma, Altitude sickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolic acidosis, Hypokalemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Loop diuretics (Option D)</strong></li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit the Na-K-2Cl <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> in the thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Furosemide, Bumetanide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, Chronic heart failure, Hypercalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, <strong>Ototoxicity, </strong>Metabolic alkalosis,</p>\n<p>Hyperglycemia,</p>\n<p>Hyperuricemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Thiazide diuretics (Option A)</strong></li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydrochlorothiazide, Chlorthalidone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, Edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, Hyponatremia,</p>\n<p>Hyperglycemia</p>\n<p>Hyperuricemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Potassium-sparing</strong></li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium channels in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"32562f5afa1692777193c891837db9\">nephron</span> or block <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spironolactone, Amiloride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure, Hyperaldosteronism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperkalemia, <span class=\"customMeta\" data-dictid=\"78cd34126d16927771887bf6b44cf6\">Gynecomastia</span> (for Spironolactone)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Osmotic diuretics (Option B)</strong></li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"612769eab6169277719463af223927\">osmolarity</span> of the <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtrate, inhibiting water reabsorption.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mannitol, Glycerin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cerebral oedema, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> glaucoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dehydration, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">Electrolyte</span> imbalance</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/s1EWHQOoUH5PbGEdpEoQ1748075513.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 27 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following drugs is appropriate for treating a 75-year-old woman with urinary incontinence triggered by stress, such as coughing?", "options": [{"label": "A", "text": "Ipratropium", "correct": false}, {"label": "B", "text": "Tolterodine", "correct": true}, {"label": "C", "text": "Telenzepine", "correct": false}, {"label": "D", "text": "Tropicamide", "correct": false}], "correct_answer": "B. Tolterodine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - T\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:100%\">\n<tbody>\n<tr>\n<td><strong>Drug</strong></td>\n<td><strong>Mechanism of Action</strong></td>\n</tr>\n<tr>\n<td><strong>Tolterodine</strong></td>\n<td>Selective <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</td>\n</tr>\n<tr>\n<td><strong>Oxybutynin</strong></td>\n<td>Muscarinic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</td>\n</tr>\n<tr>\n<td><strong>Solifenacin</strong></td>\n<td>M3 selective <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</td>\n</tr>\n<tr>\n<td><strong>Darifenacin</strong></td>\n<td>M3 selective <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</td>\n</tr>\n<tr>\n<td><strong>Fesoterodine</strong></td>\n<td>Prodrug of tolterodine, <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> antagonist</td>\n</tr>\n<tr>\n<td><strong>Trospium</strong></td>\n<td>Muscarinic <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred initial treatment for a 4-year-old boy who initially had facial swelling but now has experienced total body swelling involving the face, abdomen, scrotum, and feet, and has a urinalysis showing 4+ protein and a urine protein: creatinine ratio of 3?", "options": [{"label": "A", "text": "Prednisolone", "correct": true}, {"label": "B", "text": "Cyclophosphamide", "correct": false}, {"label": "C", "text": "Levamisole", "correct": false}, {"label": "D", "text": "Cyclosporine", "correct": false}], "correct_answer": "A. Prednisolone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A- Prednisolone&lt;br/&gt;\n&lt;br/&gt;\nExplanation: </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Duration of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Glucocorticoid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Potency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Effects/Uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Short (8-12 hrs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Hydrocortisone</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Low</p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Physiological replacement therapy, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> insufficiency, anti-inflammatory</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Intermediate (12-36 hrs)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Cortisone</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Anti-inflammatory, rheumatic disorders</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Prednisone</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Intermediate</p>\n<p> </p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Anti-inflammatory, immunosuppressive, rheumatic disorders, asthma, <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> diseases</p>\n<p>Minimal change disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Prednisolone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Intermediate to Long</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Methylprednisolone</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Intermediate to High</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Anti-inflammatory, immunosuppressive, severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conditions, multiple sclerosis.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Long </strong></p>\n<p><strong>(36-72 hrs)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Dexamethasone</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>High</p>\n<p> </p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Anti-inflammatory, immunosuppressive, severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conditions, cerebral edema.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Betamethasone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Fludrocortisone</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Mineralocorticoid activity, <span class=\"customMeta\" data-dictid=\"f955f012f716927771801d01e7d163\">adrenal</span> insufficiency, salt-wasting disorders.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a true statement regarding Aliskiren?", "options": [{"label": "A", "text": "It is indicated in diabetes mellitus", "correct": false}, {"label": "B", "text": "It is used in the treatment of diabetic nephropathy", "correct": false}, {"label": "C", "text": "It increases renin levels", "correct": true}, {"label": "D", "text": "It increases aldosterone levels", "correct": false}], "correct_answer": "C. It increases renin levels", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kA4hWuDE5wzO6vkZX8Xj1747037562.png"], "explanation": "<p>Correct Answer C - It increases &lt;span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\"&gt;renin&lt;/span&gt; levels</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aliskiren</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Direct <span class=\"customMeta\" data-dictid=\"3567fba5001692777197a712b10a39\">renin</span> <span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\">inhibitor</span> thus blocks the formation of <strong>angiotensin 1</strong>, which inhibits the RAAS and thus reduces BP.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"920\" src=\"https://image.prepladder.com/content/kA4hWuDE5wzO6vkZX8Xj1747037562.png\" width=\"735\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Heart failure</li>\n<li>Diabetic nephropathy</li>\n<li>Off-label use: Proteinuria and resistant hypertension</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diarrhoea</li>\n<li>Flu-like symptoms</li>\n<li>Peripheral edema</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is most suitable for treating edema in a patient with heart disease and presenting with breathlessness with rales?", "options": [{"label": "A", "text": "ACE inhibitors", "correct": false}, {"label": "B", "text": "Na-K-2Cl symporter inhibitor in the loop in Henle", "correct": true}, {"label": "C", "text": "Na-Cl symporter inhibitor in DCT", "correct": false}, {"label": "D", "text": "Aldosterone blocker in DCT", "correct": false}], "correct_answer": "B. Na-K-2Cl symporter inhibitor in the loop in Henle", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Na-K-2Cl &lt;span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\"&gt;symporter&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"b5fb56a28b1692777190396ae8b625\"&gt;inhibitor&lt;/span&gt; in the loop in Henle</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Loop diuretic</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Inhibit the Na-K-2Cl symporter</strong> in the <strong>thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle,</strong> increasing the <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of sodium, chloride, and water, resulting in <span class=\"customMeta\" data-dictid=\"09562877f516927771865e4cf1fd7e\">diuresis</span> and reduction of edema.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Furosemide, Bumetanide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema</p>\n</li>\n<li>\n<p>Chronic heart failure</p>\n</li>\n<li>\n<p>Hypercalcemia</p>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>\n<p>Hypokalemia,</p>\n</li>\n<li>\n<p>Ototoxicity,</p>\n</li>\n<li>\n<p>Metabolic alkalosis,</p>\n</li>\n<li>\n<p>Hyperglycemia,</p>\n</li>\n<li>\n<p>Hyperuricemia</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the drug of choice for central diabetes insipidus?", "options": [{"label": "A", "text": "Insulin", "correct": false}, {"label": "B", "text": "Desmopressin", "correct": true}, {"label": "C", "text": "Diazoxide", "correct": false}, {"label": "D", "text": "Chlorpropamide", "correct": false}], "correct_answer": "B. Desmopressin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Desmopressin</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Desmopressin</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>DDAVP, or desmopressin, is a <span class=\"customMeta\" data-dictid=\"61fbe2173416927771998e7aa0b432\">synthetic</span> <span class=\"customMeta\" data-dictid=\"22e0051a181692777181872183edb2\">analogue</span> of <span class=\"customMeta\" data-dictid=\"699f9aa3cf1692777201b501b79deb\">vasopressin</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acts on V2 receptors located in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> tubules, which increases water <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> tubule</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Diabetes insipidus(central)</li>\n<li>Nocturnal Enuresis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Route </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nasal or intravenous, as the oral route is less efficacious due to getting metabolised by <span class=\"customMeta\" data-dictid=\"be1c04825c169277720006550a3ab2\">trypsin</span> in the gut</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hyponatremia</li>\n<li>Cerebral edema</li>\n<li>Fluid overload</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on lithium developed hypertension. He was started on thiazides for hypertension. After a few days, he developed coarse tremors and other symptoms suggestive of lithium toxicity. Explain the likely mechanism of this interaction:", "options": [{"label": "A", "text": "Thiazide inhibits the metabolism of Lithium", "correct": false}, {"label": "B", "text": "Thiazide act as an add-on drug to Lithium", "correct": false}, {"label": "C", "text": "Thiazide increases the tubular resorption of Lithium", "correct": true}, {"label": "D", "text": "Thiazide causes water loss, thereby increasing the Lithium level", "correct": false}], "correct_answer": "C. Thiazide increases the tubular resorption of Lithium", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"74c7df38ec169277720012966920d9\"&gt;Thiazide&lt;/span&gt; increases the &lt;span class=\"customMeta\" data-dictid=\"98d387b7bd1692777201278b27be72\"&gt;tubular&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"797daba8ca1692777197dc9f8d3a4a\"&gt;resorption&lt;/span&gt; of &lt;span class=\"customMeta\" data-dictid=\"42659effea16927771919c6224e529\"&gt;Lithium&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Thiazides</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces the <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of sodium and <span class=\"customMeta\" data-dictid=\"f7dbd0ab551692777184f9b1a73c6d\">chloride</span> ions, leading to increased <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of these ions in the urine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypertension</li>\n<li>Edema (Congestive <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> failure, <span class=\"customMeta\" data-dictid=\"3e6e56aa3b1692777184226d2104e4\">Cirrhosis</span> and <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> dysfunction)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Electrolyte imbalances\n\t\t\t\t<ul>\n<li>Hypokalemia</li>\n<li>Hyponatremia</li>\n<li>Hypomagnesemia</li>\n<li>Hypercalcemia</li>\n</ul>\n</li>\n<li>Increased <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid</li>\n<li>Hyperglycemia</li>\n<li>Hyperlipidemia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who was diagnosed with ADPKD was prescribed Tolvaptan, and after a few weeks, he presented with dry mouth and increased thirst. What is the most likely cause of this presentation?", "options": [{"label": "A", "text": "Increased free water clearance", "correct": false}, {"label": "B", "text": "V2 receptor antagonism", "correct": true}, {"label": "C", "text": "Increased renal cAMP level", "correct": false}, {"label": "D", "text": "Increase in urine osmolality", "correct": false}], "correct_answer": "B. V2 receptor antagonism", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - V2 &lt;span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\"&gt;receptor&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"99de407a1516927771818ac910ab5f\"&gt;antagonism&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Tolvaptan</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is a medication that belongs to a class of drugs known as <span class=\"customMeta\" data-dictid=\"699f9aa3cf1692777201b501b79deb\">vasopressin</span> <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"699f9aa3cf1692777201b501b79deb\">vasopressin</span> receptors, specifically <span class=\"customMeta\" data-dictid=\"e4865847fa169277720044d7b530b0\">targeting</span> the V2 receptors</p>\n<ul>\n<li>V2 receptors are located in the <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> collecting ducts</li>\n<li>Blockade of V2 receptors reduces water <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> and promotes the <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of free water, leading to increased <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> output.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Uses </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Syndrome of Inappropriate <span class=\"customMeta\" data-dictid=\"27bd08bbaa16927771812e98e16787\">Antidiuretic</span> Hormone <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">Secretion</span> (SIADH)</li>\n<li>Autosomal Dominant <span class=\"customMeta\" data-dictid=\"ba336eb30516927771960f9d9bd85c\">Polycystic</span> <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">Kidney</span> Disease (ADPKD)</li>\n<li>Hyponatremia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Polyuria and polydipsia</li>\n<li>Dehydration</li>\n<li>Dry mouth</li>\n<li>Hypersensitivity reactions</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Contraindications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypersensitivity</li>\n<li>Concurrent use of CYP3A inhibitors - Ketoconazole, Clarithromycin</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Precautions </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Monitor <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> sodium levels - adjust dose accordingly</li>\n<li>Use with caution in patients with <span class=\"customMeta\" data-dictid=\"3268e86ce01692777188f249c64d6e\">hepatic</span> diseases</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with gout develops hypertension. The uric acid level was found to be elevated. Which of the following antihypertensives should not be used?", "options": [{"label": "A", "text": "Hydrochlorothiazide", "correct": true}, {"label": "B", "text": "Atenolol", "correct": false}, {"label": "C", "text": "Enalapril", "correct": false}, {"label": "D", "text": "Prazosin", "correct": false}], "correct_answer": "A. Hydrochlorothiazide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient who is a known case of liver cirrhosis presents with abdominal distension and swelling of the lower limbs. What is the preferred diuretic for this patient?", "options": [{"label": "A", "text": "Triamterene", "correct": false}, {"label": "B", "text": "Eplerenone", "correct": true}, {"label": "C", "text": "Chlorthalidone", "correct": false}, {"label": "D", "text": "Furosemide", "correct": false}], "correct_answer": "B. Eplerenone", "question_images": [], "explanation_images": [], "explanation": "<table>\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"1\">\n<p style=\"text-align: center;\"><strong>Eplerenone</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<p>Mineralocorticoid <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> / <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">Aldosterone</span> <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> resulting in <span class=\"customMeta\" data-dictid=\"0c980450d716927771939598e3bf30\">natriuresis</span> and reducing edema</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Primary <span class=\"customMeta\" data-dictid=\"982551b8f81692777189e20f09de85\">hyperaldosteronism</span> leading to hypertension</li>\n<li>Edema associated with liver cirrhosis, congestive <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> failure and CKD</li>\n<li>Reduced mortality in post-MI patients.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p style=\"text-align: center;\"><strong>Use in cirrhosis</strong></p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Patients with liver <span class=\"customMeta\" data-dictid=\"3e6e56aa3b1692777184226d2104e4\">cirrhosis</span> have <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> effective <span class=\"customMeta\" data-dictid=\"b9b690b70c16927771833aae799b33\">blood volume</span> due to blood accumulation in the <span class=\"customMeta\" data-dictid=\"dbdb1e19591692777199e0d8fb2522\">splanchnic</span> vessels due to vasodilatation. This results in <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of RAAS and <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of salt and water - <span class=\"customMeta\" data-dictid=\"a1146fb9d8169277718250cf1224a8\">Ascites</span> and resistance to loop diuretics.</li>\n<li>Aldosterone enters the cells in the late DCT and Collecting ducts via <span class=\"customMeta\" data-dictid=\"9c760dcb641692777186f4cda5dc95\">diffusion</span> and binds to specific <span class=\"customMeta\" data-dictid=\"35933061bb1692777192630f88863d\">mineralocorticoid</span> receptors in the <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> cytosol, which mediates sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> and <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> and H+ <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> into the tubules.</li>\n<li>Eplerenone competitively blocks this MR receptor, resulting in natriuresis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"1\" rowspan=\"1\">\n<p style=\"text-align: center;\"><strong>Side effects</strong></p>\n</td>\n<td colspan=\"1\" rowspan=\"1\">\n<ul>\n<li>Hyperkalemia</li>\n<li>No anti-androgenic effects seen</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old man joins a pilgrimage to a shrine at a mountain peak. At the summit, he develops tightness in the chest, associated with breathlessness and altered sensorium. Which of the following can be given for symptomatic relief?", "options": [{"label": "A", "text": "Mannitol", "correct": false}, {"label": "B", "text": "Digoxin", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Acetazolamide", "correct": true}], "correct_answer": "D. Acetazolamide", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/oTbp9Qc2COPoV0gpVOwq1745843494.png"], "explanation": "<p>Correct Answer D - A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was brought to the hospital following a road traffic accident. The patient is disoriented, and a CT scan of the head shows no evidence of hemorrhage but features of cerebral edema and raised intracranial pressure. Which of the following drugs can be used for the initial management of raised intracranial pressure?", "options": [{"label": "A", "text": "Chlorthiazide", "correct": false}, {"label": "B", "text": "Mannitol", "correct": true}, {"label": "C", "text": "Acetazolamide", "correct": false}, {"label": "D", "text": "Glycerol", "correct": false}], "correct_answer": "B. Mannitol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Mannitol</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Diuretic Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Notes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thiazide Diuretics</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Chlorothiazide<br/>\n\t\t\t(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypertension (effective in <span class=\"customMeta\" data-dictid=\"5297b5833216927771910b7a85de53\">low-grade</span> HTN)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Not suitable for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> fluid <span class=\"customMeta\" data-dictid=\"9d02a99d051692777194aa3375023b\">overload</span> but can be used as an adjunct.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">Anhydrase</span> Inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Acetazolamide (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glaucoma</p>\n<p>Altitude sickness</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>- Not recommended for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> or fluid overload.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Osmotic Diuretics</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mannitol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reducing <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure</p>\n<p>Acute <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>- Not used for <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> management.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the following Diuretics in column A to their site of action in column B Column A Column B Acetazolamide Torsemide Chlorthalidone Vasopressin Thick ascending loop of Henle Collecting duct Distal convoluted tubule Proximal convoluted tubule", "options": [{"label": "A", "text": "A-2, B-3, C-1, D-4", "correct": false}, {"label": "B", "text": "A-3, B-4, C-2, D-1", "correct": false}, {"label": "C", "text": "A-1, B-2, C-4, D-3", "correct": false}, {"label": "D", "text": "A-4, B-1, C-3, D-2", "correct": true}], "correct_answer": "D. A-4, B-1, C-3, D-2", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diuretics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> tubule, decreasing <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetazolamide, Methazolamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma, Altitude sickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Metabolic acidosis, Hypokalemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Loop diuretics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit the Na-K-2Cl <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> in the thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Furosemide, Bumetanide,</p>\n<p><strong>Torsemide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, Chronic heart failure, Hypercalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, <strong>Ototoxicity, </strong>Metabolic alkalosis,</p>\n<p>Hyperglycemia,</p>\n<p>Hyperuricemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thiazide diuretics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydrochlorothiazide, Chlorthalidone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, Edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypokalemia, Hyponatremia,</p>\n<p>Hyperglycemia</p>\n<p>Hyperuricemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potassium-sparing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium channels in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"32562f5afa1692777193c891837db9\">nephron</span> or block <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spironolactone, Amiloride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure, Hyperaldosteronism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hyperkalemia, <span class=\"customMeta\" data-dictid=\"78cd34126d16927771887bf6b44cf6\">Gynecomastia</span> (for Spironolactone)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osmotic diuretics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"612769eab6169277719463af223927\">osmolarity</span> of the <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtrate, inhibiting water reabsorption.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mannitol, Glycerin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cerebral oedema, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> glaucoma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dehydration, <span class=\"customMeta\" data-dictid=\"2e0552462e16927771871413861fb7\">Electrolyte</span> imbalance</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs increases uric acid in urine?", "options": [{"label": "A", "text": "Colchicine", "correct": false}, {"label": "B", "text": "Febuxostat", "correct": false}, {"label": "C", "text": "Probenecid", "correct": true}, {"label": "D", "text": "Allopurinol", "correct": false}], "correct_answer": "C. Probenecid", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"2ee374b25c16927771963eae834a26\"&gt;Probenecid&lt;/span&gt; </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uricosuric drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit OAPT transporter/ URAT-1 in <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> ⇒ Inhibits <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> ⇒ Increase <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>1. Probenecid: </strong></p>\n<ul>\n<li>Side effects: diarrhoea, hypersensitivity, <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid stones</li>\n<li>Contraindication: nephrolithiasis, <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Precaution: take plenty of oral fluids</li>\n<li>Concomitant <span class=\"customMeta\" data-dictid=\"e6c39cccfc1692777184f4ea5296e6\">colchicine</span> or NSAIDs indicated in attack of gout</li>\n</ul>\n<p><strong>2. Sulphinpyrazole:</strong></p>\n<ul>\n<li>Non-steroidal anti-inflammatory drug</li>\n<li>Recommended in both <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> and chronic gout</li>\n</ul>\n<p><strong>3. Benzbromarone:</strong></p>\n<ul>\n<li>Safe in <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure</li>\n<li>Contraindication – Liver diseases</li>\n</ul>\n<p><strong>4. Lesinurad</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attack of gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>DOC- NSAIDS (All types) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Except for <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and paracetamol</li>\n<li>Anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Colchicine (spindle poison) (Option A) </strong></p>\n<p style=\"text-align: center;\"> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>MOA: <span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\">microtubule</span> inhibitor</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attacks of <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> and <span class=\"customMeta\" data-dictid=\"5dda3cc2ab1692777202b3b3c65bea\">familial</span> Mediterranean fever and is also the <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for karyotyping</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intra <span class=\"customMeta\" data-dictid=\"cd001152fe16927771823275439a2d\">articular</span> injections, avoid oral route</li>\n<li>Immunosuppressive and anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for chronic gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitors</strong></p>\n<ul>\n<li>Allopurinol (DOC) <strong>(Option D)</strong></li>\n<li>Oxipurinol</li>\n<li>Febuxostat <strong>(Option B) </strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>MOA: Blocks <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> → Inhibits the conversion of <span class=\"customMeta\" data-dictid=\"304c30e55316927771895062b17e8b\">hypoxanthine</span> to <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid in the liver.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uric acid <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> enzyme</strong></p>\n<ul>\n<li>Pegloticase</li>\n<li>Rasburicase</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>MOA: <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid is converted to <span class=\"customMeta\" data-dictid=\"eae976dfa31692777181804c2b20e7\">allantoin</span> and excreted in urine</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uricosuric agents</strong></p>\n<ul>\n<li>Probenecid <strong>(OptionC)</strong></li>\n<li>Benzbromaron</li>\n<li>Sulfinpyrazone</li>\n<li>Lesinurad</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>MOA: <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">Inhibit</span> OATP transporter/URAT-1 in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> → inhibits <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid → increased <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid.</p>\n<p>(OATP - Organic <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> transport protein, URAT-1 - <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid transporter)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Four friends are planning a trip to Ladakh. During their stay, one of them began experiencing headaches, nausea, dizziness, and fatigue. Which of the following is the most appropriate treatment for this patient?", "options": [{"label": "A", "text": "Sumatriptan", "correct": false}, {"label": "B", "text": "Promethazine", "correct": false}, {"label": "C", "text": "Scopolamine", "correct": false}, {"label": "D", "text": "Acetazolamide", "correct": true}], "correct_answer": "D. Acetazolamide", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2EkdNJYbXfFCHG5hx9It1746170522.png"], "explanation": "<p>Correct Answer D - A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old woman was prescribed a diuretic by a doctor to manage hypertension. Which of the following diuretic acts on the site 'A' is marked in the given image?", "options": [{"label": "A", "text": "Furosemide", "correct": false}, {"label": "B", "text": "Hydrochlorothiazide", "correct": true}, {"label": "C", "text": "Acetazolamide", "correct": false}, {"label": "D", "text": "Mannitol", "correct": false}], "correct_answer": "B. Hydrochlorothiazide", "question_images": ["https://image.prepladder.com/notes/TkfGgb09BwqaYF7LVRZ81747394851.png"], "explanation_images": ["https://image.prepladder.com/notes/Yj1qluxT8bBtJnQ5fpWv1747394940.png"], "explanation": "<p>Correct Answer B - Hydrochlorothiazide</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Class &amp; Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Side effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors </strong></p>\n<ul>\n<li>Acetazolamide <strong>(Option C)</strong></li>\n<li>Methazolamide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> tubule, decreasing <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glaucoma, Altitude sickness</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Metabolic acidosis, Hypokalemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Loop diuretics </strong></p>\n<ul>\n<li>Furosemide <strong>(Option A)</strong></li>\n<li>Bumetanide</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit the Na-K-2Cl <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> in the thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, Chronic heart failure, Hypercalcemia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypokalemia, <strong>Ototoxicity, </strong>Metabolic alkalosis,</li>\n<li>Hyperglycemia,</li>\n<li>Hyperuricemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Thiazide diuretics </strong></p>\n<ul>\n<li>Hydrochlorothiazide<strong> (Option B)</strong></li>\n<li>Chlorthalidone</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypertension, Edema</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Hypokalemia, Hyponatremia,</li>\n<li>Hyperglycemia</li>\n<li>Hyperuricemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Potassium-sparing</strong></p>\n<ul>\n<li>Spironolactone</li>\n<li>Amiloride</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibit sodium channels in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"32562f5afa1692777193c891837db9\">nephron</span> or block <span class=\"customMeta\" data-dictid=\"210102fdef1692777181bab45bdfe3\">aldosterone</span> receptors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Heart failure, Hyperaldosteronism</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hyperkalemia, Gynecomastia (for Spironolactone)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Osmotic diuretics</strong></p>\n<ul>\n<li>Mannitol <strong>(Option D)</strong></li>\n<li>Glycerin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"612769eab6169277719463af223927\">osmolarity</span> of the <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtrate, inhibiting water reabsorption.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cerebral oedema, Acute glaucoma</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dehydration, Electrolyte imbalance</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A female patient complains of swelling and pain in her great toe. Her uric acid level is found to be high. A drug that reduces uric acid levels is prescribed. Which of the following enzymes should the drug inhibit?", "options": [{"label": "A", "text": "Urease", "correct": false}, {"label": "B", "text": "Homogentisate oxidase", "correct": false}, {"label": "C", "text": "Lysyl oxidase", "correct": false}, {"label": "D", "text": "Xanthine oxidase", "correct": true}], "correct_answer": "D. Xanthine oxidase", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ZFeZZMDg3Cd2F0mjMBIf1746169580.png"], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\"&gt;Xanthine&lt;/span&g\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attack of gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>DOC- NSAIDS (All types) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Except <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and paracetamol</li>\n<li>Anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Colchicine (spindle poison)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>MOA: <span class=\"customMeta\" data-dictid=\"ef00bb99bd1692777192dbc816b3d4\">microtubule</span> inhibitor</li>\n<li>Used in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> attacks of <span class=\"customMeta\" data-dictid=\"0b216ac0561692777188160d9a8814\">gout</span> and <span class=\"customMeta\" data-dictid=\"5dda3cc2ab1692777202b3b3c65bea\">familial</span> Mediterranean fever and is also the <span class=\"customMeta\" data-dictid=\"357ecf18f2169277718661a76111ea\">DOC</span> for karyotyping</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corticosteroids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intra <span class=\"customMeta\" data-dictid=\"cd001152fe16927771823275439a2d\">articular</span> injections, avoid oral route</li>\n<li>Immunosuppressive and anti-inflammatory</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs for chronic gout</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Xanthine <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> inhibitors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include <span class=\"customMeta\" data-dictid=\"6337926de316927771812a6842721f\">Allopurinol</span> (DOC), Oxipurinol, Febuxostat</li>\n<li>MOA: Blocks <span class=\"customMeta\" data-dictid=\"c9a23eabc41692777202d1d98467d5\">xanthine</span> <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> → Inhibits the conversion of <span class=\"customMeta\" data-dictid=\"304c30e55316927771895062b17e8b\">hypoxanthine</span> to <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid in the liver.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uric acid <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">oxidase</span> enzyme</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include <span class=\"customMeta\" data-dictid=\"953ec049a6169277719556031fce96\">Pegloticase</span> and Rasburicase</li>\n<li>MOA: <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid is converted to <span class=\"customMeta\" data-dictid=\"eae976dfa31692777181804c2b20e7\">allantoin</span> and excreted in urine</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uricosuric agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Drugs include Probenecid, Benzbromaron, Sulfinpyrazone, Lesinurad</li>\n<li>MOA: <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">Inhibit</span> OATP transporter/URAT-1 in the <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> → inhibits <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid → increased <span class=\"customMeta\" data-dictid=\"0f7653c9ef1692777187deaa35f749\">excretion</span> of <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">uric</span> acid.</li>\n</ul>\n<p> </p>\n<p>(OATP - Organic <span class=\"customMeta\" data-dictid=\"53e82fca731692777181e629a02799\">anion</span> transport protein, URAT-1 - <span class=\"customMeta\" data-dictid=\"ffa20262931692777201caef35de16\">Uric</span> acid transporter)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was started on dialysis, and he developed disequilibrium. Which of the following drugs should be started?", "options": [{"label": "A", "text": "Ethacrynic acid", "correct": false}, {"label": "B", "text": "Mannitol", "correct": true}, {"label": "C", "text": "Bumetanide", "correct": false}, {"label": "D", "text": "Nesiritide", "correct": false}], "correct_answer": "B. Mannitol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following diuretics is matched correctly with its primary site of action? 1) Osmotic diuretics - Distal convoluted tubule. 2) Thiazide diuretics - Proximal convoluted tubule 3) Carbonic anhydrase inhibitors - Proximal convoluted tubule 4) Potassium-sparing diuretics - Collecting duct.", "options": [{"label": "A", "text": "1, 2, and 3", "correct": false}, {"label": "B", "text": "3 and 4", "correct": true}, {"label": "C", "text": "2, 3, and 4", "correct": false}, {"label": "D", "text": "1 and 2.", "correct": false}], "correct_answer": "B. 3 and 4", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - 3 and 4\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Osmotic diuretics</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Proximal <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> <span class=\"customMeta\" data-dictid=\"4ba1c48e851692777201a91713191e\">tubule</span> and <span class=\"customMeta\" data-dictid=\"0cf8ac70611692777186b133d027f6\">descending</span> limb of the loop of Henle</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thiazide diuretics</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Distal <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Proximal <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Potassium-sparing diuretics</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Collecting duct</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the mechanism of action of thiazides in DCT?", "options": [{"label": "A", "text": "Blockade of Na Cl symporter", "correct": false}, {"label": "B", "text": "Blockade of Na K 2Cl symporter", "correct": true}, {"label": "C", "text": "Blockade of aldosterone receptors", "correct": false}, {"label": "D", "text": "Blockade of epithelial sodium channels.", "correct": false}], "correct_answer": "B. Blockade of Na K 2Cl symporter", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical uses</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in the <span class=\"customMeta\" data-dictid=\"bdbac654081692777196f9aab116f0\">proximal</span> tubule, decreasing <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> reabsorption</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acetazolamide, Methazolamide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma, Altitude sickness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Loop diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit the Na-K-2Cl <span class=\"customMeta\" data-dictid=\"1bede64bc91692777199b477cf43f1\">symporter</span> in the thick <span class=\"customMeta\" data-dictid=\"62f0d7c8491692777182ab7cc82edb\">ascending</span> loop of Henle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Furosemide, Bumetanide</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> edema, Chronic heart failure, Hypercalcemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thiazide diuretics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit sodium <span class=\"customMeta\" data-dictid=\"3086fd09371692777197a351ddde07\">reabsorption</span> in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> tubule</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hydrochlorothiazide, Chlorthalidone</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypertension, Edema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Potassium</strong></p>\n<p><strong>Sparing diuretics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibit block the epithelial sodium channels in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> <span class=\"customMeta\" data-dictid=\"3ddb367f1c16927771854815522adf\">convoluted</span> <span class=\"customMeta\" data-dictid=\"4ba1c48e851692777201a91713191e\">tubule</span> and collecting duct</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spironolactone, Amiloride</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Heart failure, Hyperaldosteronism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Osmotic diuretics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase <span class=\"customMeta\" data-dictid=\"612769eab6169277719463af223927\">osmolarity</span> of the <span class=\"customMeta\" data-dictid=\"1ad1e71a4a1692777188853097f685\">glomerular</span> filtrate, inhibiting water reabsorption.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mannitol, Glycerin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cerebral oedema, Acute glaucoma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old male experiences headache, nausea, and shortness of breath while trekking. The physician prescribes a drug to alleviate his symptoms. The drug administered primarily acts on which part of the nephron?", "options": [{"label": "A", "text": "Proximal convoluted tubule (PCT)", "correct": true}, {"label": "B", "text": "Loop of Henle", "correct": false}, {"label": "C", "text": "Distal convoluted tubule (DCT)", "correct": false}, {"label": "D", "text": "Collecting duct (CD)", "correct": false}], "correct_answer": "A. Proximal convoluted tubule (PCT)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/AJk0aNkS8zd671lJp5yC1741042325.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is not treated with high-ceiling diuretics?", "options": [{"label": "A", "text": "Generalized edema", "correct": false}, {"label": "B", "text": "Cerebral edema", "correct": false}, {"label": "C", "text": "Acute pulmonary edema", "correct": false}, {"label": "D", "text": "Pulmonary hypertension", "correct": true}], "correct_answer": "D. Pulmonary hypertension", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Pulmonary h\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Drug Name</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Brand Name</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Onset of Action</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Duration of Action</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Dose</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Furosemide</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Lasix</p>\n</td>\n<td>\n<p style=\"text-align: center;\">30-60 min</p>\n</td>\n<td>\n<p style=\"text-align: center;\">6-8 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">20-160 mg orally, 20-40 mg IV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Bumetanide</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Bumex</p>\n</td>\n<td>\n<p style=\"text-align: center;\">30-60 min</p>\n</td>\n<td>\n<p style=\"text-align: center;\">4-6 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">0.5-2 mg orally, 0.5-1 mg IV</p>\n</td>\n</tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Torsemide</p>\n</td>\n<td>\n<p style=\"text-align: center;\">Demadex</p>\n</td>\n<td>\n<p style=\"text-align: center;\">60 min</p>\n</td>\n<td>\n<p style=\"text-align: center;\">6-8 hours</p>\n</td>\n<td>\n<p style=\"text-align: center;\">10-40 mg orally, 10-20 mg IV</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30-year-old man joins a pilgrimage to a shrine at a mountain peak . At the summit, he develops tightness in the chest, associated with breathlessness and altered sensorium . Which of the following can be given for symptomatic relief?", "options": [{"label": "A", "text": "Mannitol", "correct": false}, {"label": "B", "text": "Digoxin", "correct": false}, {"label": "C", "text": "Diltiazem", "correct": false}, {"label": "D", "text": "Acetazolamide", "correct": true}], "correct_answer": "D. Acetazolamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which one of the listed medications acts as a carbonic anhydrase inhibitor?", "options": [{"label": "A", "text": "Acetazolamide", "correct": true}, {"label": "B", "text": "Hydrochlorothiazide", "correct": false}, {"label": "C", "text": "Furosemide", "correct": false}, {"label": "D", "text": "Mannitol", "correct": false}], "correct_answer": "A. Acetazolamide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the preferred medication for treating neurogenic diabetes insipidus?", "options": [{"label": "A", "text": "Conivaptan", "correct": false}, {"label": "B", "text": "Vasopressin", "correct": false}, {"label": "C", "text": "Terlipressin", "correct": false}, {"label": "D", "text": "Desmopressin", "correct": true}], "correct_answer": "D. Desmopressin", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - D\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Central (Neurogenic)</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Peripheral (Nephrogenic)</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>No <span class=\"customMeta\" data-dictid=\"401dd7c3941692777180e4d78eee80\">ADH</span> is produced</p>\n</td>\n<td>\n<p>ADH is produced, but V2 receptors are resistant/mutated</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>The drug of choice is Desmopressin (DOC)</p>\n</td>\n<td>\n<p>The drug of choice is <span class=\"customMeta\" data-dictid=\"74c7df38ec169277720012966920d9\">Thiazide</span> diuretics</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following drugs does not require dose reduction in patients with renal failure ?", "options": [{"label": "A", "text": "Gentamicin", "correct": false}, {"label": "B", "text": "Vancomycin", "correct": false}, {"label": "C", "text": "Amphotericin B", "correct": false}, {"label": "D", "text": "Doxycycline", "correct": true}], "correct_answer": "D. Doxycycline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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It is only triggered by aspirin.", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - \n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">\n<p><strong>Other Name</strong></p>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">\n<p>Aspirin-Exacerbated <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">Respiratory</span> Disease (AERD)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\"><strong>Key Characteristics</strong></td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">\n<ul>\n<li>Asthma</li>\n<li>Nasal polyps</li>\n<li>Sensitivity to <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and other NSAIDs with COX-1 inhibition</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\"><strong>Triggering Agents</strong></td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">Aspirin and other NSAIDs that <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> COX-1, such as <span class=\"customMeta\" data-dictid=\"5778d7dc361692777189571125f0bd\">ibuprofen</span> and naproxen</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\"><strong>Pathophysiology</strong></td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">Overproduction of leukotrienes due to the <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> of COX-1, leading to <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> symptoms</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\"><strong>Common Symptoms</strong></td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">\n<ul>\n<li>Worsening of asthma</li>\n<li>Nasal <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> and sinusitis</li>\n<li>Recurrence of <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> polyps</li>\n<li>Respiratory <span class=\"customMeta\" data-dictid=\"afafb9026e1692777186e3dd168fa8\">distress</span> after <span class=\"customMeta\" data-dictid=\"b924074dfe16927771933b6d50eaac\">NSAID</span> ingestion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\"><strong>Management</strong></td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:top\">\n<ul>\n<li>Avoidance of <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> and COX-1 inhibiting NSAIDs</li>\n<li>Leukotriene <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists (e.g., montelukast)</li>\n<li>Desensitization therapy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A group of people are travelling to the mountains, and a girl starts complaining of mountain sickness. What is the drug of choice?", "options": [{"label": "A", "text": "Promethazine", "correct": false}, {"label": "B", "text": "Acetazolamide", "correct": true}, {"label": "C", "text": "Dimenhydrinate", "correct": false}, {"label": "D", "text": "Thiazide", "correct": false}], "correct_answer": "B. Acetazolamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a cough and thick sputum. What should be the drug given to this patient?", "options": [{"label": "A", "text": "Bromhexine", "correct": true}, {"label": "B", "text": "Codeine", "correct": false}, {"label": "C", "text": "Dextromethorphan", "correct": false}, {"label": "D", "text": "Benzonatate", "correct": false}], "correct_answer": "A. Bromhexine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Bromh\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient comes to you with increased cough, breathlessness, and decreased exercise capacity. Chest X-ray shows pulmonary fibrosis. Which drug can be administered in the given condition?", "options": [{"label": "A", "text": "Bortezomib", "correct": false}, {"label": "B", "text": "Roflumilast", "correct": false}, {"label": "C", "text": "Imatinib", "correct": false}, {"label": "D", "text": "Pirfenidone", "correct": true}], "correct_answer": "D. Pirfenidone", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Pirfenidone </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Management of <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">Interstitial</span> lung disease </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Disease </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Idiopathic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> fibrosis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pirfenidone + Nintedanib</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Nonspecific <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> pneumonitis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Prednisolone + <span class=\"customMeta\" data-dictid=\"a6ed2a5f63169277718507c569e576\">cyclophosphamide</span> or rituximab</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Desquamative <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> pneumonitis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corticosteroids</strong> or <strong>Cytotoxic agents (Azathioprine) </strong></p>\n<p><strong>Bronchodilators </strong>may be used</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cryptogenic organising pneumonia</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corticosteroids</strong></p>\n<p>Cyclophosphamide or <span class=\"customMeta\" data-dictid=\"e3802f488416927771979c6d76c756\">Rituximab</span> can be used alternatively</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hamman-Rich syndrome</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanical <span class=\"customMeta\" data-dictid=\"a58f1f33f81692777201ad5e0d60ca\">ventilation</span> </strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with chronic obstructive pulmonary disease (COPD) is already on inhaled salmeterol therapy, but they are currently experiencing no improvement and have presented to the outpatient department. Which of the following medications can be included in their treatment plan?", "options": [{"label": "A", "text": "Theophylline", "correct": false}, {"label": "B", "text": "Azithromycin", "correct": false}, {"label": "C", "text": "Oral glucocorticoids", "correct": false}, {"label": "D", "text": "Ipratropium", "correct": true}], "correct_answer": "D. Ipratropium", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Vg20tLxuydwWoVh0GiuK1745843191.png", "https://image.prepladder.com/content/5oJj2IFNmMtgR8uNq6fj1745843195.png"], "explanation": "<p>Correct Answer D - Ipratropiu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which one of the following medications utilized in the immediate treatment of asthma does not exert its effects by widening the bronchial airways?", "options": [{"label": "A", "text": "Salbutamol", "correct": false}, {"label": "B", "text": "Ipratropium", "correct": false}, {"label": "C", "text": "Deriphylline", "correct": false}, {"label": "D", "text": "Hydrocortisone", "correct": true}], "correct_answer": "D. Hydrocortisone", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/PGnYACzY8q6bhiBZMkUX1746017113.png"], "explanation": "<p>Correct Answer D - H\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a centrally acting opioid antitussive?", "options": [{"label": "A", "text": "Ambroxol", "correct": false}, {"label": "B", "text": "Diphenoxylate", "correct": false}, {"label": "C", "text": "Levopropoxyphene", "correct": true}, {"label": "D", "text": "Levorphanol", "correct": false}], "correct_answer": "C. Levopropoxyphene", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Levopropoxyph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Paradoxical bronchoconstriction is seen with ipratropium bromide due to all of the following except?", "options": [{"label": "A", "text": "Hypertonic saline", "correct": true}, {"label": "B", "text": "EDTA", "correct": false}, {"label": "C", "text": "Benzalkonium chloride", "correct": false}, {"label": "D", "text": "Prejunctional M2 receptor Blockade", "correct": false}], "correct_answer": "A. Hypertonic saline", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/zKPKmPT23Z5aBJZk7t281745570148.png"], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"f97c39ea7a1692777189ea0ea68b49\"&gt;Hypertonic&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "If codeine is coming to the market in combination with dextromethorphan as an anti-tussive, this combination ____________.", "options": [{"label": "A", "text": "Should not be used due to risk of addiction", "correct": false}, {"label": "B", "text": "Can be used as both have different mechanisms of action", "correct": false}, {"label": "C", "text": "Should not be used as it is irrational", "correct": true}, {"label": "D", "text": "Can be used to treat cough effectively", "correct": false}], "correct_answer": "C. Should not be used as it is irrational", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - Should not be u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common drawback of the given device?", "options": [{"label": "A", "text": "Bacterial contamination", "correct": false}, {"label": "B", "text": "Does not provide multiple doses", "correct": false}, {"label": "C", "text": "Drug deposition in the oropharynx", "correct": true}, {"label": "D", "text": "Not portable", "correct": false}], "correct_answer": "C. Drug deposition in the oropharynx", "question_images": ["https://image.prepladder.com/content/utd2GBPj5jHP7OTdPJsA1745822551.png"], "explanation_images": ["https://image.prepladder.com/content/3nqEVVUcDmFyMpqtwasw1745822604.png"], "explanation": "<p>Correct Answer C - Drug deposition in the oroph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Theophylline causes diuresis due to which of the following mechanisms?", "options": [{"label": "A", "text": "Adenosine agonism", "correct": true}, {"label": "B", "text": "PDE 4 inhibition", "correct": false}, {"label": "C", "text": "Beta-2-agonism", "correct": false}, {"label": "D", "text": "PDE 3 inhibition", "correct": false}], "correct_answer": "A. Adenosine agonism", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/EKWzz1rxxXDwcfGKYp8a1746436283.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following agents is not used in the management of bronchial asthma?", "options": [{"label": "A", "text": "Phosphodiesterase inhibitors", "correct": false}, {"label": "B", "text": "Steroids", "correct": false}, {"label": "C", "text": "Beta-agonist", "correct": false}, {"label": "D", "text": "Cholinergic drugs", "correct": true}], "correct_answer": "D. Cholinergic drugs", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - &lt;span class=\"customMeta\" data-dictid=\"8656dac49a16927771846b41f8cf19\"&gt;Cholinergic&lt;/span&gt; drugs&lt;br/&gt;\n&lt;br/&gt;\nExplanation: </p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Drugs used in <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Category </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Examples </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uses </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Short-acting beta-agonists (SABAs) </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Albuterol (Salbutamol), Levalbuterol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates beta-2 <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> receptors, causing bronchial smooth muscle relaxation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acute relief of <span class=\"customMeta\" data-dictid=\"9bde62b1091692777183cd433d9d47\">bronchospasm</span> in <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> attacks (rescue medication).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Long-acting beta-agonists (LABAs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Salmeterol, Formoterol</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Prolonged <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> of beta-2 receptors for bronchodilation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Maintenance therapy (always used with ICS).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anticholinergics (Short-acting)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipratropium</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"0ad3c97c2916927771938768dcf298\">muscarinic</span> receptors, reducing bronchoconstriction.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Alternative or <span class=\"customMeta\" data-dictid=\"8fabe131a916927771802a448a329c\">additive</span> for <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> asthma, especially with SABAs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Inhaled Corticosteroids (ICS) (Option B)</strong><br/>\n\t\t\t </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Beclomethasone, Budesonide, Fluticasone</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"3b9dd3166f1692777180b697887ccb\">airway</span> <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and prevents exacerbations</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>First-line maintenance therapy in persistent asthma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Leukotriene <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonists (LTRAs)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Montelukast, Zafirlukast</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blocks <span class=\"customMeta\" data-dictid=\"5a4fd169911692777191c1cb27b0d7\">leukotriene</span> receptors, reducing <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and bronchoconstriction.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Maintenance therapy, especially in mild <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> or aspirin-induced asthma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mast Cell Stabilizers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sodium Cromoglycate, Nedocromil</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"1f95a52091169277719133cc234fe0\">mast</span> cell degranulation, reducing <span class=\"customMeta\" data-dictid=\"a993f205b0169277719284faad4c87\">mediator</span> release.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Preventive therapy for mild persistent <span class=\"customMeta\" data-dictid=\"76891bb6e91692777182cda16e1db6\">asthma</span> or exercise-induced asthma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Biologics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Omalizumab</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Binds to IgE, preventing its interaction with receptors on <span class=\"customMeta\" data-dictid=\"1f95a52091169277719133cc234fe0\">mast</span> cells.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Moderate to severe <span class=\"customMeta\" data-dictid=\"6ca07f1f771692777181a8a66497a2\">allergic asthma</span> uncontrolled with <span class=\"customMeta\" data-dictid=\"e2c420c53d1692777189e40c773793\">ICS</span> and LABAs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Methylxanthines</strong></p>\n<p><strong>(Option A)</strong><br/>\n\t\t\t </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Theophylline, Aminophylline</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Non-selective <span class=\"customMeta\" data-dictid=\"646159048c1692777195054877afc9\">phosphodiesterase</span> <span class=\"customMeta\" data-dictid=\"f03ca2d2a716927771901227bc175a\">inhibition</span> leads to <span class=\"customMeta\" data-dictid=\"075923f4c01692777183a26fd689e3\">bronchodilation</span> and anti-inflammatory effects.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Add-on therapy in severe or difficult-to-control asthma.</p>\n<p>Most commonly used in COPD rather than asthma.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is NOT a side effect of salbutamol?", "options": [{"label": "A", "text": "Tachycardia", "correct": false}, {"label": "B", "text": "Tolerance", "correct": false}, {"label": "C", "text": "Hypokalemia", "correct": false}, {"label": "D", "text": "Hypoglycemia", "correct": true}], "correct_answer": "D. Hypoglycemia", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<thead>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Adverse Effect of salbutamol</strong></p>\n</td>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>\n<p>Tachycardia</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Tremors</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nervousness</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Headache</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Dizziness</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hypokalaemia</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Palpitations</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Muscle cramps</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Insomnia</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Nausea</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which anti-asthma drug should be avoided with Erythromycin ?", "options": [{"label": "A", "text": "Salbutamol", "correct": false}, {"label": "B", "text": "Theophylline", "correct": true}, {"label": "C", "text": "Terbutaline", "correct": false}, {"label": "D", "text": "Ipratropium", "correct": false}], "correct_answer": "B. Theophylline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Theoph\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a side effect of salbutamol ?", "options": [{"label": "A", "text": "Hypoglycemia", "correct": true}, {"label": "B", "text": "Hypokalemia", "correct": false}, {"label": "C", "text": "Tremors", "correct": false}, {"label": "D", "text": "Tachycardia", "correct": false}], "correct_answer": "A. Hypoglycemia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Hypog\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Her pulmonary function tests show a significant decline in FEV1 compared to her baseline. Sputum culture reveals Pseudomonas aeruginosa. She has been compliant with her routine medications, including a CFTR modulator, mucolytics, and pancreatic enzyme replacement therapy. Which of the following pharmacological adjustments is the most appropriate next step in managing this patient's current clinical condition?", "options": [{"label": "A", "text": "Add inhaled tobramycin to her current regimen", "correct": false}, {"label": "B", "text": "Switch her CFTR modulator to a different one", "correct": false}, {"label": "C", "text": "Increase the dose of her mucolytic agent", "correct": false}, {"label": "D", "text": "Start intravenous ceftazidime and tobramycin", "correct": true}], "correct_answer": "D. Start intravenous ceftazidime and tobramycin", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5yh03MdSvzCpSxuIR3XN1746776297.mp3", "video": ""}, {"text": "Which of the following statements is false regarding the mechanism of action of theophylline?", "options": [{"label": "A", "text": "Inhibit phosphodiesterase 4", "correct": false}, {"label": "B", "text": "Block A1 receptors", "correct": false}, {"label": "C", "text": "Activation of NF kappa B", "correct": true}, {"label": "D", "text": "Cause histone acetylation", "correct": false}], "correct_answer": "C. Activation of NF kappa B", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/P4GuNEgcImtmeW27Foa11736448315.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GWPaWJFMi9J6B2PWIpTW1746773354.mp3", "video": ""}, {"text": "A 45-year-old female patient presents with progressive dyspnea on exertion and fatigue. She has a history of systemic sclerosis and is diagnosed with pulmonary arterial hypertension (PAH) based on right heart catheterization, which shows elevated pulmonary arterial pressures. The patient is initiated on inhaled nitric oxide (NO) therapy as part of her treatment plan. Which of the following statements best describes the mechanism by which inhaled nitric oxide improves her symptoms?", "options": [{"label": "A", "text": "Nitric oxide acts by increasing systemic blood pressure, thereby the workload on the left ventricle", "correct": false}, {"label": "B", "text": "Nitric oxide decreases the production of inflammatory cytokines, thereby reducing pulmonary artery inflammation and fibrosis.", "correct": false}, {"label": "C", "text": "Nitric oxide causes selective pulmonary vasodilation, decreasing pulmonary vascular resistance and alleviating right ventricular strain.", "correct": true}, {"label": "D", "text": "Nitric oxide increases the proliferation of endothelial cells in pulmonary arteries, promoting vascular remodeling and reducing hypertension.", "correct": false}], "correct_answer": "C. Nitric oxide causes selective pulmonary vasodilation, decreasing pulmonary vascular resistance and alleviating right ventricular strain.", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/5fYRKpkorAInGQNd8VAm1736448620.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yUoF8mHzIv4as1aYSDRX1746776107.mp3", "video": ""}, {"text": "A 45-year-old female patient with a history of asthma and nasal polyps presents with wheezing, shortness of breath, and chest tightness. She reports that her symptoms began shortly after taking aspirin for a headache. On examination, she has diffuse wheezing and reduced breath sounds bilaterally. She is given supplemental oxygen, and nebulized bronchodilators are started. What is the mechanism through which aspirin is producing above symptoms ?", "options": [{"label": "A", "text": "Inhibition of cyclooxygenase-1 (COX-1) leading to increased leukotriene production", "correct": true}, {"label": "B", "text": "Direct stimulation of the beta-2 adrenergic receptors causing bronchoconstriction", "correct": false}, {"label": "C", "text": "Inhibition of lipoxygenase leading to decreased leukotriene production", "correct": false}, {"label": "D", "text": "Blocking of the muscarinic receptors in the bronchial smooth muscle", "correct": false}], "correct_answer": "A. Inhibition of cyclooxygenase-1 (COX-1) leading to increased leukotriene production", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/4IEAePlvDFNlRmtMg70i1736448507.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vucoLGCyEA6z8tgQVjYf1746775810.mp3", "video": ""}, {"text": "During a diagnostic workup for a patient presenting with symptoms of suspected pulmonary arterial hypertension (PAH), a vaso-reactive testing procedure is planned. The patient undergoes right heart catheterization, and baseline hemodynamic measurements are recorded. Subsequently, a vasoactive medication is administered directly into the pulmonary circulation through the catheter. What outcome of vaso-reactive testing in PAH would indicate a positive response?", "options": [{"label": "A", "text": "A positive response indicates a decrease in mean pulmonary artery pressure of at least 10 mmHg", "correct": true}, {"label": "B", "text": "A positive response indicates a reduction in pulmonary vascular resistance of at least 10%", "correct": false}, {"label": "C", "text": "A negative response indicates a favourable response to vasodilator medications.", "correct": false}, {"label": "D", "text": "Calcium channel blockers are contraindicated in positive responders.", "correct": false}], "correct_answer": "A. A positive response indicates a decrease in mean pulmonary artery pressure of at least 10 mmHg", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/HEv1A4IH99ClKDrnkxb11736448419.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TIctKvbvYQVL1VdKHHoI1746774953.mp3", "video": ""}, {"text": "A 45-year-old female presents to the cardiology clinic with complaints of increasing shortness of breath. She was diagnosed with pulmonary artery hypertension. Which of the following correctly describes the mechanism of action with respect to the drug? Drug Mechanism of Action 1. Bosentan A. Prostaglandin I-2 agonist 2. Selexipag B. Prostacyclin (PGI-2) analogue 3. Riociguat C. Endothelin receptor antagonist 4. Epoprostenol D. Soluble guanylate cyclase stimulator", "options": [{"label": "A", "text": "1-C, 2-A, 3-D, 4-B", "correct": true}, {"label": "B", "text": "1-B, 2-D, 3-C, 4-A", "correct": false}, {"label": "C", "text": "1-D, 2-B, 3-A, 4-C", "correct": false}, {"label": "D", "text": "1-A, 2-C, 3-B, 4-D", "correct": false}], "correct_answer": "A. 1-C, 2-A, 3-D, 4-B", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Mechanism of action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>PDE 5 Inhibitors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Sildenafil (Viagra), Tadalafil</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Endothelin <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">Receptor</span> Antagonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Bosentan, Sitaxsentan, Ambrisentan</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>PG-I2 Analogs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Treprostinil, Iloprost, Epoprostenol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Soluble <span class=\"customMeta\" data-dictid=\"69ea502f9316927771884f58d6fad1\">Guanylyl</span> <span class=\"customMeta\" data-dictid=\"b638747a661692777185a6182d6e5f\">Cyclase</span> Activators</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Riociguat</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>I-2 <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> agonist</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Selexipag</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Continuous NO Inhalation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Nitric oxide</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Calcium Channel Blockers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Amlodipine, Nifedipine</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/asVex0gPB565VAlQjNRo1746774537.mp3", "video": ""}, {"text": "Which of the following best describes the role of corticosteroids in asthma management?", "options": [{"label": "A", "text": "Corticosteroids are bronchodilators", "correct": false}, {"label": "B", "text": "Corticosteroids are only used for severe asthma attacks.", "correct": false}, {"label": "C", "text": "Corticosteroids are limited to maintenance therapy for chronic asthma.", "correct": false}, {"label": "D", "text": "Corticosteroids are used in both acute exacerbations and chronic management of asthma, with their administration route varying by use case.", "correct": true}], "correct_answer": "D. Corticosteroids are used in both acute exacerbations and chronic management of asthma, with their administration route varying by use case.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Route</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples with use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhalational Corticosteroids</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DOC- Chronic or persistent asthma</p>\n<p>Eg:</p>\n<ul>\n<li>Beclomethasone</li>\n<li>Fluticasone-Most Potent</li>\n<li>Mometasone</li>\n<li>Triamcinolone</li>\n<li>Budesonide- Most commonly used</li>\n<li>Ciclesonide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral Corticosteroids</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recommended for <span class=\"customMeta\" data-dictid=\"3790c638ab16927771970a0a41d3ab\">refractory</span> asthma</p>\n<p>Eg: Prednisolone</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>IV Corticosteroids</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recommended for status asthmaticus</p>\n<p>Eg:</p>\n<ul>\n<li>Hydrocortisone</li>\n<li>Dexamethasone</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8ppTPBZWLFI63csZKXSU1746774297.mp3", "video": ""}, {"text": "A 12-year-old child with a history of asthma presents with symptoms of coughing, wheezing, and shortness of breath, particularly during physical activities. The child has been using a short-acting beta-agonist inhaler as needed but continues to experience frequent asthma symptoms. The physician decides to add a medication that does not cause bronchodilation but restricts the inflammatory mediators implicated in asthma. Which medication is being referred to in this scenario?", "options": [{"label": "A", "text": "Sodium cromoglycate", "correct": true}, {"label": "B", "text": "Salmeterol", "correct": false}, {"label": "C", "text": "Magnesium sulfate", "correct": false}, {"label": "D", "text": "Theophylline", "correct": false}], "correct_answer": "A. Sodium cromoglycate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YJkXAvUDI41KOm5as6NP1746773966.mp3", "video": ""}, {"text": "A 45-year-old female with a history of asthma presents with acute shortness of breath and wheezing. Despite initial treatment with inhaled bronchodilators and systemic corticosteroids, her symptoms persist. Which of the following can be used to manage this presentation?", "options": [{"label": "A", "text": "Magnesium sulfate", "correct": true}, {"label": "B", "text": "N-acetylcysteine", "correct": false}, {"label": "C", "text": "Bromhexine", "correct": false}, {"label": "D", "text": "Montelukast", "correct": false}], "correct_answer": "A. Magnesium sulfate", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dJeUReXB7cN5LOfth80Z1746773768.mp3", "video": ""}, {"text": "A 65-year-old male with a history of COPD on medication presented to the ER with complaints of headache and chest pain. His ECG showed ventricular arrhythmia, and he subsequently experienced a seizure. He had recently begun taking the anti-gout medication allopurinol. What medication is he likely using for COPD?", "options": [{"label": "A", "text": "Theophylline", "correct": true}, {"label": "B", "text": "Albuterol", "correct": false}, {"label": "C", "text": "Ipratropium", "correct": false}, {"label": "D", "text": "Fluticasone", "correct": false}], "correct_answer": "A. Theophylline", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs reducing the effect of theophylline</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs increasing the effect of theophylline</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CYP <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> inducers</li>\n<li>Drugs include\n\t\t\t\t<ul>\n<li>Griseofulvin</li>\n<li>Phenobarbitone</li>\n<li>Phenytoin</li>\n<li>Rifampicin</li>\n</ul>\n</li>\n<li>Smoking and alcohol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>CYP inhibitors</li>\n<li>Drugs include\n\t\t\t\t<ul>\n<li>Ciprofloxacin</li>\n<li>Omeprazole</li>\n<li>Cimetidine</li>\n<li>Allopurinol</li>\n<li>Erythromycin</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>1.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Seizures</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Blockage of <span class=\"customMeta\" data-dictid=\"d3f6a49b7416927771802124ccddf0\">adenosine</span> A1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> in <span class=\"customMeta\" data-dictid=\"4aa6035df41692777190b41d4a1583\">kidney</span> and neuron</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #0d0d0d; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>2.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Urination</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #0d0d0d; vertical-align:top\"> \n\t\t\t<p>3.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>GIT disturbances</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #42ccf9; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Inhibition of <span class=\"customMeta\" data-dictid=\"646159048c1692777195054877afc9\">phosphodiesterase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in GIT and blood vessels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n<p>4.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Headache</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>5.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Arrhythmias</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blockage of <span class=\"customMeta\" data-dictid=\"d3f6a49b7416927771802124ccddf0\">adenosine</span> A1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> in heart</p>\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"646159048c1692777195054877afc9\">phosphodiesterase</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> in heart</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OggOrEsO8cq1nDpC9Nn41746773548.mp3", "video": ""}, {"text": "A 60-year-old patient has symptoms of a productive cough and difficulty clearing thick mucus from their airways. The patient has a history of COPD and frequently experiences episodes of breathing difficulties. Which of the following drugs can be used to reduce the viscosity of the mucus, thus increasing its clearance in this patient?", "options": [{"label": "A", "text": "Albuterol", "correct": false}, {"label": "B", "text": "Dextromethorphan", "correct": false}, {"label": "C", "text": "Bromhexine", "correct": true}, {"label": "D", "text": "Guaifenesin", "correct": false}], "correct_answer": "C. Bromhexine", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/LTq52Q5hbxu9JryjvK5Y1736447595.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CCnzw1qt4OqKoKbNvBru1746610543.mp3", "video": ""}, {"text": "A 65-year-old male with a long history of chronic obstructive pulmonary disease (COPD) is prescribed an anticholinergic to help manage his symptoms. At his follow-up appointment, he reports experiencing increased shortness of breath and wheezing shortly after using his inhaler. Which of the following causes paradoxical bronchoconstriction?", "options": [{"label": "A", "text": "Tiotropium", "correct": false}, {"label": "B", "text": "Ipratropium", "correct": true}, {"label": "C", "text": "Oxitropium", "correct": false}, {"label": "D", "text": "Umeclidinium", "correct": false}], "correct_answer": "B. Ipratropium", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/NtxldwAbqzwM1T59sH2e1736448227.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1l4c863gMKp3kF4ajDHf1746773188.mp3", "video": ""}, {"text": "A 68-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents to the clinic for a routine follow-up. He reports experiencing increased shortness of breath and wheezing, particularly during physical activity. He is on albuterol used as needed, and the physician decides to add ipratropium. Which of the following is the mechanism of action of the latter?", "options": [{"label": "A", "text": "𝛃2 receptor agonist", "correct": false}, {"label": "B", "text": "M2 receptor agonist", "correct": false}, {"label": "C", "text": "M2 receptor antagonist", "correct": false}, {"label": "D", "text": "M3 receptor antagonist", "correct": true}], "correct_answer": "D. M3 receptor antagonist", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/zXMbhXwVtpD7y5WNZN2W1736447978.png", "https://image.prepladder.com/content/9kT1xKEDJxY84vwwizuh1736448069.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drug</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Use</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ipratropium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>M3 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibition of <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">parasympathetic</span> tone, leading to bronchodilation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>COPD</strong>, <strong>asthma</strong> (often in combination with β2 agonists)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Albuterol</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>β2 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> agonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bronchodilation through smooth muscle relaxation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Acute asthma</strong>, <strong>COPD</strong> relief</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tiotropium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>M3 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonist</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Longer-acting bronchodilation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>COPD</strong>, <strong>asthma</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RxCoJzoOrSdxxmxPMZat1746611650.mp3", "video": ""}, {"text": "A 30-year-old male with a history of asthma complains of wheezing, shortness of breath, and nighttime awakenings occurring about twice a week, with each episode lasting more than a day. His current medication regimen includes a SABA. Pulmonary function tests show a FEV1 of 70% predicted. Which is the most appropriate pharmacological management for this patient's condition?", "options": [{"label": "A", "text": "Low-dose inhaled corticosteroids", "correct": false}, {"label": "B", "text": "High-dose inhaled corticosteroids", "correct": false}, {"label": "C", "text": "Long-acting beta-agonists and low-dose inhaled corticosteroids", "correct": true}, {"label": "D", "text": "Oral corticosteroids", "correct": false}], "correct_answer": "C. Long-acting beta-agonists and low-dose inhaled corticosteroids", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/L8WsEncVPmqQZ6uh6v801736447867.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Asthma classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs and symptoms</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild intermittent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild symptoms up to 2 days a week and up to 2 nights a month</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild persistent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms &gt;2 times a week but not &gt;1 time in a single day</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate persistent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms every day and &gt;1 time/ week at night</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe persistent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms throughout the day on most days and also frequent awakenings at night</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0fQCjGbc7HuO4S3j3g8r1746611470.mp3", "video": ""}, {"text": "A 25-year-old asthmatic presents with severe respiratory distress and is unresponsive to her albuterol inhaler. She has a respiratory rate of 32, oxygen saturation of 88%, and audible wheezing. Initial treatment with high-dose nebulized albuterol and systemic corticosteroids has shown only minimal improvement. What is the most appropriate next step in managing her condition?", "options": [{"label": "A", "text": "Repeat", "correct": false}, {"label": "B", "text": "Aminophylline", "correct": false}, {"label": "C", "text": "Ipratropium", "correct": false}, {"label": "D", "text": "Magnesium sulfate", "correct": true}], "correct_answer": "D. Magnesium sulfate", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/yvyNMX0vCvzBrwxkTcsb1736447790.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cRDoRieAN312EHr4B5gW1746611306.mp3", "video": ""}, {"text": "A 24-year-old male presents with shortness of breath, wheezing, and chest tightness. He has a known history of asthma. On examination, he appears distressed, with an RR of 30/min, HR of 110/min, and a SpO2 of 92% on room air. Auscultation reveals widespread wheezing. Which of the following is the most appropriate initial pharmacological management for this presentation?", "options": [{"label": "A", "text": "Oral Prednisone 40 mg", "correct": false}, {"label": "B", "text": "Inhaled Salbutamol 2.5 mg via nebulizer", "correct": true}, {"label": "C", "text": "Inhaled Fluticasone 100 mcg", "correct": false}, {"label": "D", "text": "Montelukast 10 mg orally", "correct": false}], "correct_answer": "B. Inhaled Salbutamol 2.5 mg via nebulizer", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dAo8I74s08BMwKdrXamG1746611101.mp3", "video": ""}, {"text": "A 42-year-old female patient with a history of severe asthma presents with frequent exacerbations despite being on corticosteroids. She is about to get started on omalizumab. Which of the following mechanisms best describes the action of omalizumab?", "options": [{"label": "A", "text": "Inhibiting leukotriene synthesis", "correct": false}, {"label": "B", "text": "Blocking the activity of TNF-alpha", "correct": false}, {"label": "C", "text": "Neutralizing free IgE in circulation", "correct": true}, {"label": "D", "text": "Suppressing eosinophil activation", "correct": false}], "correct_answer": "C. Neutralizing free IgE in circulation", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/MlI0U8lEGTDsoQiqeYsj1736447701.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recombinant humanized <span class=\"customMeta\" data-dictid=\"b2b82438d6169277719287eb450079\">monoclonal</span> antibody</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Target</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Free IgE</strong> in the bloodstream</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binds to IgE → prevents binding to FcεRI on <span class=\"customMeta\" data-dictid=\"1f95a52091169277719133cc234fe0\">mast</span> cells and basophils</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Result</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreased allergen-induced <span class=\"customMeta\" data-dictid=\"1f95a52091169277719133cc234fe0\">mast</span> cell degranulation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate-to-severe <strong>allergic asthma</strong>, chronic urticaria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Administration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subcutaneous <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> every 2–4 weeks</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Notable Adverse Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Injection site reactions, <span class=\"customMeta\" data-dictid=\"d6d717efa216927771819fee139235\">anaphylaxis</span> (rare), headache</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gYG9VVqALV6NB4k6HDl61746610898.mp3", "video": ""}, {"text": "A 12-year-old female patient with cystic fibrosis (CF) presents to the clinic with increased cough and thick sputum production, causing shortness of breath and fatigue. Which of the following medications would be the most effective for this patient?", "options": [{"label": "A", "text": "Pancrelipase", "correct": false}, {"label": "B", "text": "Dornase alfa", "correct": true}, {"label": "C", "text": "Cevimeline", "correct": false}, {"label": "D", "text": "Lumacaftor", "correct": false}], "correct_answer": "B. Dornase alfa", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptom</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dry eyes, mouth (Xerophthalmia, xerostomia)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pilocarpine</li>\n<li><strong>Cevimeline (Option C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hard mucus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mucolytics -\n\t\t\t\t<ul>\n<li>N acetylcysteine</li>\n<li>Erdosteine</li>\n<li>Carbocysteine</li>\n<li>Dornase <span class=\"customMeta\" data-dictid=\"a9268f2e1d16927771814cfef69cf4\">alpha</span> (Degrades DNA)</li>\n<li>Hypertonic saline</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recurrent <span class=\"customMeta\" data-dictid=\"1000989d33169277719652247cd559\">pneumonia</span> (Pseudomonas)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inhalational antibiotics -\n\t\t\t\t<ul>\n<li>Tobramycin</li>\n<li>Amikacin</li>\n<li>Colistin</li>\n<li>Aztreonam</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic pancreatitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pancreatic <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> replacement (Pancrezyme)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Disease-modifying therapy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Lumacaftor (Option D)</strong></li>\n<li>Ivacaftor</li>\n<li>Elexacaftor</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RNU2qKTq83cTAVYnXu9J1745663890.mp3", "video": ""}, {"text": "A 30-year-old female presented with complaints of a persistent dry cough for the past week and an antitussive was prescribed. Two days later, the patient returned with nausea, vomiting, and constipation. Which centrally acting antitussive medication is most likely responsible for these adverse effects in this patient?", "options": [{"label": "A", "text": "Codeine", "correct": true}, {"label": "B", "text": "Dextromethorphan", "correct": false}, {"label": "C", "text": "Noscapine", "correct": false}, {"label": "D", "text": "Promethazine", "correct": false}], "correct_answer": "A. Codeine", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Class</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adverse effects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Opioids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Morphine\n\t\t\t\t<ul>\n<li>Hydromorphone</li>\n<li>Oxymorphone</li>\n</ul>\n</li>\n<li>Codeine\n\t\t\t\t<ul>\n<li>Hydrocodone</li>\n<li>Oxycodone</li>\n<li>Pholcodine</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Suppress <span class=\"customMeta\" data-dictid=\"8f02e74e821692777185a0c005c508\">cough</span> centre</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Codeine -</p>\n<ul>\n<li>Constipation</li>\n<li>Respiratory depression</li>\n<li>Drowsiness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non Opioids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dextromethorphan</li>\n</ul>\n<ul>\n<li>Noscapine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dextromethorphan- Acts on <span class=\"customMeta\" data-dictid=\"ada5fcf7e416927771886ff24152ff\">glutamate</span> receptor-NMDA antagonist.</li>\n<li>Noscapine-Sigma agonist</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dextromethorphan-</p>\n<ul>\n<li>Dizziness</li>\n<li>Nausea</li>\n<li>Drowsiness</li>\n<li>At high doses-\n\t\t\t\t<ul>\n<li>Hallucinations</li>\n<li>Ataxia</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antihistaminic drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cetirizine</li>\n<li>Promethazine</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>H1 <span class=\"customMeta\" data-dictid=\"9e4959f6f316927771978bb152d440\">receptor</span> antagonists</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drowsiness</li>\n<li>Sedation</li>\n<li>Somnolence</li>\n<li>Fatigue</li>\n<li>Headache</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/84CX4HdAM1wrTNCv0Rq11746610715.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 29 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the following drugs with the conditions they are used to treat: Conditions Drugs 1. Delirium Tremens a. Naloxone 2. Acute Alcoholism b. Oxazepam 3. Smoking Cessation c. Acamprosate 4. Opioid Poisoning d. Varenicline", "options": [{"label": "A", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}, {"label": "B", "text": "1-b, 2-a, 3-d, 4-c", "correct": false}, {"label": "C", "text": "1-c, 2-b, 3-a, 4-d", "correct": false}, {"label": "D", "text": "1-b, 2-c, 3-d, 4-a", "correct": true}], "correct_answer": "D. 1-b, 2-c, 3-d, 4-a", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:518px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Conditions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p style=\"text-align: center;\"><strong>Drugs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Delirium Tremens</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Oxazepam</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Acute Alcoholism</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Acamprosate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Smoking Cessation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Varenicline</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Opioid Poisoning</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Naloxone</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 11 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); // Create scrollable container for explanation content resultsContent.innerHTML = ` <div class="border-4 ${isCorrect ? 'border-green-600 bg-green-100' : userAnswer ? 'border-red-600 bg-red-100' : 'border-gray-400 bg-gray-50'} p-4 rounded-lg overflow-hidden"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <!-- Scrollable container for explanation --> <div class="mt-2 overflow-x-auto"> ${q.explanation || 'No explanation available'} </div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-[#2c5281] text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">